Sertraline For Tinnitus: What's The Verdict?

Sertraline For Tinnitus

Tinnitus, the persistent perception of sound in the absence of external stimuli, can be a distressing experience affecting individuals' well-being. While its origins and treatment options continue to be explored, a fascinating, but confusing, relationship has emerged between tinnitus and a commonly prescribed medication: Sertraline. This article delves into the current evidence and insights regarding the use of Sertraline in managing tinnitus.

Sertraline, famously recognized by its brand name 'Zoloft,' has long been associated with treating depression and anxiety. However, its potential impact on tinnitus has sparked interest in the medical community. Tinnitus, often characterized by persistent ringing or buzzing in the ears, has elusive origins and limited treatment options. Recent studies indicate that Sertraline's mechanism of action, as a selective serotonin reuptake inhibitor (SSRI), might offer insights into addressing tinnitus.

The anatomy and physiology of tinnitus. Image by macrovector on Freepik

Evidence in Focus: Research Findings

• A comprehensive study from 2010, reviewed here, established Sertraline's effectiveness in treating depression over decades. This supports its potential role in addressing tinnitus, given the link between mood and auditory disturbances.
  
  
• Notably, a double-blinded RCT from 2006 looked at the use of Sertraline in patients with severe tinnitus. Participants were assigned to receive either 50 mg of Sertraline (once daily) or a placebo for 16 weeks. The results showed that Sertraline was more effective in reducing tinnitus severity and loudness, and improvements correlated with reduced depressive and anxiety symptoms.
  
  
• Nonetheless, a systematic review from 2012, mentioned here, explored antidepressant use for tinnitus. That systematic review concluded that the evidence remained inconclusive, but that the intricate relationship between mood and auditory perception warrants further investigation. 
  
  
• On the other hand, there are case reports showcasing that tinnitus can, in rare cases, develop as a side effect of Sertraline. There are also reports of tinnitus appearing as a withdrawal symptom of discontinuation antidepressants, such as Sertraline.
  
  
• Most recently, Tang et al. (2017) delved into serotonin's role in tinnitus. The researchers highlight how SSRIs, such as Sertraline, may exacerbate the condition. The study focuses on serotonin's impact on brain activity. Neurons in the dorsal cochlear nucleus, essential for tinnitus and sensory integration, become hyperactive and oversensitive to stimuli when exposed to serotonin.

Treating Tinnitus With Sertraline: The Conclusion

• To conclude the above evidence, the research surrounding Sertraline's impact on tinnitus presents a complex picture. While some studies suggest its potential effectiveness in mitigating tinnitus severity and loudness, others highlight concerns about the exacerbation of symptoms. The intricate relationship between mood, auditory perception, and the effects of Sertraline on tinnitus requires further investigation. As medical science evolves, a more comprehensive understanding of Sertraline's role in tinnitus management will probably emerge, aiding clinicians in making informed decisions for patients experiencing both depression and tinnitus.
  
  
• Like other complex neurological disorders, one drug is unlikely to resolve tinnitus in all patients, and, thus, therapies targeting specific subgroups are likely to yield the greatest success. Considering Sertraline in patients with comorbid depression or anxiety may be an option. 
  
  
• Note that Sertraline is not FDA-approved for the treatment of tinnitus.

Side Effects and Considerations

• Common side effects include dizziness, nausea, dry mouth, and sleep disturbances.
  
  
• Recent research has shed light on emotional blunting, a side effect that may impact individuals taking SSRIs like Sertraline. Dosage adjustments or alternative treatments may be considered if emotional blunting occurs.
  
  
• The FDA has issued a black box warning for Sertraline due to an increased risk of suicidal thoughts and behaviors in children and adolescents.

Caution and Contraindications

• Sertraline for tinnitus should be approached cautiously if there are moderate-to-severe liver issues.
  
  
• Individuals with allergies to Sertraline or other selective serotonin reuptake inhibitors should avoid its use.
  
  
• Individuals who have taken or are currently taking MAOI medications in the past 14 days should avoid Sertraline due to potential interactions.

Useful Information For Sertraline Use

• Starting with a low dose and gradually increasing it can help mitigate the common side effects of Sertraline.
  
  
• Mild to moderate side effects typically subside within the initial weeks of treatment.
  
  
• When discontinuing Sertraline treatment for tinnitus, a gradual dose reduction may minimize the risk of withdrawal or rebound symptoms.

Cover image by DCStudio on Freepik

Author: J. Martin, M.D. 
Last updated: November 11, 2023

Disclaimer: The information provided is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider, such as a physician, before starting any new treatment or making changes to your existing treatment plan. Individual responses to treatment may vary, and a healthcare professional can provide personalized guidance based on your specific needs and circumstances. If you are experiencing severe or persistent symptoms of disease or mental illness, seek immediate medical attention.