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A randomized trial of nortriptyline for severe chronic tinnitus. Effects on depression, disability, and tinnitus symptoms.
Arch Intern Med. 1993 Oct 11; 153(19):2251-9.AI

Abstract

OBJECTIVE

To determine whether the antidepressant, nortriptyline, is effective for treatment of depression, tinnitus-related disability, and tinnitus symptoms in patients with severe chronic tinnitus.

DESIGN

A 12-week, double-blind, randomized controlled trial.

SETTING

A university otolaryngology clinic.

PATIENTS

Ninety-two subjects with severe chronic tinnitus: 38 with current major depression and 54 with depressive symptoms and significant tinnitus-related disability.

INTERVENTION

Nortriptyline (maintained at 50 to 150 mg/mL for 6 weeks) or placebo.

MAIN OUTCOME MEASURES

Hamilton Depression Rating Scale, Tinnitus Disability Measures, and Audiometric Measures.

RESULTS

Nortriptyline was superior to placebo by multivariate analysis of covariance for depression (10.6 vs 14.3 final Hamilton Depression score), for tinnitus-related disability (1.8 vs 2.4 final MPI Tinnitus Interference), and tinnitus loudness (13.6 vs 20.0 dB final loudness match [in worst ear at tinnitus frequency]). When major depression and depressive symptoms groups were considered separately, nortriptyline was superior to placebo on these same measures but differences did not achieve statistical significance.

CONCLUSIONS

The antidepressant nortriptyline decreases depression, functional disability, and tinnitus loudness associated with severe chronic tinnitus. What appears to be irreversible disability of otologic origin may, in part, be reversible disability of psychiatric origin.

Authors+Show Affiliations

Department of Psychiatry and Behavioral Sciences, University of Washington Medical School, Seattle.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

8215728

Citation

Sullivan, M, et al. "A Randomized Trial of Nortriptyline for Severe Chronic Tinnitus. Effects On Depression, Disability, and Tinnitus Symptoms." Archives of Internal Medicine, vol. 153, no. 19, 1993, pp. 2251-9.
Sullivan M, Katon W, Russo J, et al. A randomized trial of nortriptyline for severe chronic tinnitus. Effects on depression, disability, and tinnitus symptoms. Arch Intern Med. 1993;153(19):2251-9.
Sullivan, M., Katon, W., Russo, J., Dobie, R., & Sakai, C. (1993). A randomized trial of nortriptyline for severe chronic tinnitus. Effects on depression, disability, and tinnitus symptoms. Archives of Internal Medicine, 153(19), 2251-9.
Sullivan M, et al. A Randomized Trial of Nortriptyline for Severe Chronic Tinnitus. Effects On Depression, Disability, and Tinnitus Symptoms. Arch Intern Med. 1993 Oct 11;153(19):2251-9. PubMed PMID: 8215728.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized trial of nortriptyline for severe chronic tinnitus. Effects on depression, disability, and tinnitus symptoms. AU - Sullivan,M, AU - Katon,W, AU - Russo,J, AU - Dobie,R, AU - Sakai,C, PY - 1993/10/11/pubmed PY - 1993/10/11/medline PY - 1993/10/11/entrez SP - 2251 EP - 9 JF - Archives of internal medicine JO - Arch Intern Med VL - 153 IS - 19 N2 - OBJECTIVE: To determine whether the antidepressant, nortriptyline, is effective for treatment of depression, tinnitus-related disability, and tinnitus symptoms in patients with severe chronic tinnitus. DESIGN: A 12-week, double-blind, randomized controlled trial. SETTING: A university otolaryngology clinic. PATIENTS: Ninety-two subjects with severe chronic tinnitus: 38 with current major depression and 54 with depressive symptoms and significant tinnitus-related disability. INTERVENTION: Nortriptyline (maintained at 50 to 150 mg/mL for 6 weeks) or placebo. MAIN OUTCOME MEASURES: Hamilton Depression Rating Scale, Tinnitus Disability Measures, and Audiometric Measures. RESULTS: Nortriptyline was superior to placebo by multivariate analysis of covariance for depression (10.6 vs 14.3 final Hamilton Depression score), for tinnitus-related disability (1.8 vs 2.4 final MPI Tinnitus Interference), and tinnitus loudness (13.6 vs 20.0 dB final loudness match [in worst ear at tinnitus frequency]). When major depression and depressive symptoms groups were considered separately, nortriptyline was superior to placebo on these same measures but differences did not achieve statistical significance. CONCLUSIONS: The antidepressant nortriptyline decreases depression, functional disability, and tinnitus loudness associated with severe chronic tinnitus. What appears to be irreversible disability of otologic origin may, in part, be reversible disability of psychiatric origin. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/8215728/A_randomized_trial_of_nortriptyline_for_severe_chronic_tinnitus__Effects_on_depression_disability_and_tinnitus_symptoms_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/153/pg/2251 DB - PRIME DP - Unbound Medicine ER -