Drugs that cause tinnitus (ringing ears) 

Describe Tinnitus

Tinnitus is a condition where a person hears ringing, buzzing, clicking, or other phantom sounds in one or both ears, even when there is no external source of the noise. About 15% to 20% of people suffer from it, primarily older adults. A few drugs can cause tinnitus.

Drugs may cause tinnitus 

Symptoms

• People with tinnitus may experience:
• Ringing, buzzing, clicking, or hissing sounds.
• Sounds that vary in pitch and intensity.
• Phantom noises can be either constant or intermittent.

Types of tinnitus

Tinnitus comes in different forms, each with unique characteristics and causes. Here are the main types:

1. Subjective Tinnitus

• The most prevalent type.
• Only the affected person can hear the ringing or buzzing.
• Exposure to loud noise, ear infections, or certain medications can cause ear infections.

2. Objective Tinnitus

• An uncommon variety in which a physician can hear the sound through a stethoscope.
• It is usually linked to vascular or muscular issues, such as aneurysms or muscle spasms.

3. Somatic Tinnitus

• The intensity of the sound changes with body movement.
• This condition is often associated with issues in the neck or jaw, such as temporomandibular joint (TMJ) disorders.

4. Pulsatile Tinnitus

• There is a rhythmic noise that matches the heartbeat.
• This condition is often caused by changes in blood flow near the ear.

5. Musical Tinnitus (Musical Hallucination)

• This refers to the perception of music or singing when no music is playing.
• This condition is more common in people with hearing loss or neurological conditions.
• Each type has different treatment approaches, depending on the underlying cause. 

Tinnitus's origins

Although tinnitus can be caused by a variety of factors, it is often linked to issues with the ears or nervous system. Here are some common causes:

1. Hearing Loss

• Tinnitus results from age-related hearing loss, which is caused by deterioration of the inner ear.
• Noise-induced hearing loss— Exposure to loud sounds can damage the ear’s hair cells.

2. Ear Conditions

• Earwax accumulation: Too much earwax can obstruct the ear canal and result in tinnitus.
• Ear infections—Inflammation or fluid buildup can trigger ringing in the ears.
• Ménière’s disease—A disorder affecting the inner ear, often accompanied by dizziness.

3. Circulatory System Issues

• High blood pressure—Increased blood flow near the ear can cause pulsatile tinnitus.
• Atherosclerosis—Narrowed arteries can lead to abnormal blood flow sounds.
• Vascular disorders—Conditions affecting blood vessels near the ear may contribute.

4. Neurological & Musculoskeletal Causes

• Temporomandibular joint (TMJ) disorders—jaw problems can affect ear function.
• Head or neck injuries—Trauma can disrupt auditory pathways.
• Overactive thyroid—Hormonal imbalances may contribute to tinnitus.

5. Medications & Other Factors

• Certain drugs—some antibiotics, antidepressants, and anti-inflammatory medications—can trigger tinnitus.
• Smoking & alcohol—These substances can affect circulation and worsen symptoms.
• Stress & anxiety—Psychological factors can heighten tinnitus perception.

Medical conditions of tinnitus

Tinnitus can be linked to several medical conditions, often affecting the ears, nervous system, or circulatory system. Here are some common conditions associated with tinnitus:

Ear & Hearing Conditions

• Age-related hearing loss—The inner ear deteriorates over time, leading to tinnitus.
• Noise-induced hearing loss— Exposure to loud sounds can damage the ear’s hair cells.
• Ménière’s disease—A disorder affecting the inner ear, often accompanied by dizziness and hearing loss.
• Ear infections—Inflammation or fluid buildup can trigger ringing in the ears.
• Earwax blockage—Excess earwax can obstruct the ear canal and cause tinnitus.
• Neurological & Musculoskeletal Conditions
• Temporomandibular joint (TMJ) disorders—jaw problems can affect ear function.
• Head or neck injuries—Trauma can disrupt auditory pathways, leading to tinnitus.
• Multiple sclerosis is a neurological disorder that can affect hearing and cause tinnitus.

Circulatory System Disorders

• High blood pressure—Increased blood flow near the ear can cause pulsatile tinnitus.
• Atherosclerosis—Narrowed arteries can lead to abnormal blood flow sounds.
• Vascular malformations—Abnormal blood vessel structures near the ear may contribute.

Other Medical Conditions

• Diabetes can affect circulation and nerve function, potentially leading to tinnitus.
• Thyroid disorders—Hormonal imbalances may contribute to tinnitus symptoms.
• Autoimmune diseases—Conditions like lupus or rheumatoid arthritis may have links to tinnitus.

Tinnitus is often a symptom rather than a standalone condition, so addressing the underlying medical issue can help manage its effects. If tinnitus is persistent or worsening, consulting a healthcare provider is recommended.

Medications that cause tinnitus

Certain medications can cause or worsen tinnitus as a side effect. These drugs are often referred to as ototoxic, meaning they can harm the inner ear. Here are some common types:

1. Pain Relievers (Analgesics)

• High-dose aspirin
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)
• Acetaminophen (Tylenol)

2. Antibiotics

• Aminoglycosides (e.g., gentamicin, neomycin)
• Macrolides (e.g., erythromycin, azithromycin)

3. Chemotherapy Drugs

• Cisplatin
• Carboplatin

4. Diuretics (Water Pills)

• Furosemide (Lasix)
• Bumetanide

5. Antidepressants & Anti-Anxiety Medications

• Selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine, sertraline)
• Tricyclic antidepressants (e.g., amitriptyline, nortriptyline)
• Benzodiazepines (e.g., diazepam, lorazepam)

6. Blood Pressure Medications

• Beta blockers (e.g., propranolol)
• ACE inhibitors (e.g., lisinopril)

7. Anti-Malarial Drugs

• Chloroquine
• Quinine

Tinnitus caused by medications is often temporary and may resolve once the drug is discontinued. However, in some cases, it can be permanent. If you suspect a medication is causing tinnitus, consult a healthcare provider before making any changes.

Also read https://www.britannica.com/science/tinnitus.

Tinnitus diagnosis

Tinnitus diagnosis typically involves a combination of medical history review, physical examination, and specialized tests to determine the underlying cause. Here’s how it’s generally assessed:

1. Medical History & Physical Examination

• Your doctor will ask about your symptoms, including the type of sounds you hear, their frequency, and any associated conditions.
• They may check for earwax buildup, ear infections, or jaw and neck issues that could contribute to tinnitus.

2. Hearing Tests (Audiometry)

• You may undergo a hearing exam in a soundproof room, where specific sounds are played to assess your hearing ability.
• This technique helps determine if tinnitus is linked to hearing loss.

3. Imaging Tests

• CT scans or MRI scans may be recommended if structural abnormalities or tumors are suspected.
• These tests help rule out vascular disorders, acoustic neuromas, or other neurological conditions.

4. Blood Tests

• Blood tests may be conducted to check for anemia, thyroid disorders, or high blood pressure, which can contribute to tinnitus.

5. Movement & Neurological Tests

• Your doctor may ask you to move your eyes, clench your jaw, or turn your neck to see if tinnitus changes.
• This can help identify musculoskeletal causes like TMJ disorders.

6. Pulsatile Tinnitus Assessment

• If your tinnitus follows your heartbeat, it may be pulsatile tinnitus, often linked to circulatory system issues.
• To examine blood vessel abnormalities, additional tests might be required.

Since tinnitus can have multiple causes, a thorough diagnosis is essential for determining the best treatment approach. If you’re experiencing persistent tinnitus, consulting an ENT specialist or audiologist is recommended.

Tinnitus Treatment & Management

The video explains how to manage tinnitus

While there is no universal cure, tinnitus can be managed through

Medical Treatments

• Treating underlying conditions—addressing issues like earwax buildup, infections, or circulatory problems.
• Hearing aids—useful for those with tinnitus linked to hearing loss.
• Medications—Some antidepressants and anti-anxiety drugs may help reduce tinnitus perception.

Therapies

• Sound therapy—using white noise machines or soothing sounds to mask tinnitus.
• Cognitive behavioral therapy (CBT)—Helps patients cope with tinnitus-related distress.
• Tinnitus retraining therapy (TRT)—combines counseling and sound therapy to help the brain ignore tinnitus.

Lifestyle & Home Remedies

• Avoid loud noises—protect your ears from excessive noise exposure.
• Reduce stress—stress management techniques like meditation and deep breathing can help.
• Limit caffeine and alcohol—these substances may worsen tinnitus symptoms.
• Exercise and a healthy diet—maintaining overall health can improve tinnitus management.

Treatment & Management

• Lifestyle changes—reducing caffeine intake, managing stress, and avoiding loud noises.
• If tinnitus is persistent or interferes with daily life, consulting a healthcare provider is recommended. 

Alternative Treatments

• Acupuncture—Some people find relief through acupuncture sessions.
• Herbal supplements—Certain supplements like ginkgo biloba are believed to help, though scientific evidence is limited.
• If tinnitus is persistent or worsening, consulting an ENT specialist or audiologist is recommended. You can find more details on tinnitus treatment here. 

How to prevent tinnitus

Preventing tinnitus involves protecting your ears and maintaining overall health. Here are some effective strategies:

1. Protect Your Ears

• Avoid loud noises—prolonged exposure to loud sounds can damage hearing.
• In noisy situations, use ear protection by donning noise-canceling headphones or earplugs.
• Keep volume levels low—when using headphones, follow the 60/60 rule (60% volume for no more than 60 minutes at a time).

2. Maintain Good Health

• Manage blood pressure—high blood pressure can contribute to tinnitus.
• Exercise regularly—it improves circulation and overall ear health.
• Eat a balanced diet—nutrients like magnesium and zinc may support ear function.

3. Reduce Risk Factors

• Limit caffeine and alcohol—these substances can worsen tinnitus symptoms.
• Avoid smoking—smoking affects circulation and can increase tinnitus risk.
• Manage stress—stress and anxiety can heighten tinnitus perception.

4. Take Care of Your Ears

• Avoid excessive earwax buildup—clean ears safely without inserting objects.
• Treat ear infections promptly—untreated infections can lead to complications.
• Stay hydrated—proper hydration supports inner ear function.

Natural treatments for tinnitus

Alternative treatments for tinnitus focus on natural and holistic approaches to managing symptoms. While scientific evidence varies, some people find relief through these methods:

1. Herbal Supplements

• Ginkgo biloba—believed to improve blood circulation to the ears.
• Acai Red Asian ginseng—May support nerve health.
• Zinc & magnesium—essential minerals that may aid ear function.

2. Acupuncture

• Some individuals report reduced tinnitus symptoms after acupuncture sessions.
• Thought to help by improving circulation and reducing stress.

3. Mindfulness & Relaxation Techniques

• Meditation & yoga can help manage stress, which may worsen tinnitus.
• Deep breathing exercises may reduce anxiety linked to tinnitus perception.

4. Sound Therapy

• White noise machines—mask tinnitus sounds with soothing background noise.
• Music therapy—Listening to altered frequencies may help retrain the brain.

5. Chiropractic & TMJ Treatment

• Chiropractic adjustments—May help if tinnitus is linked to neck or jaw issues.
• TMJ therapy—Treating jaw disorders can reduce tinnitus symptoms.

6. Dietary Changes

• Reducing caffeine & alcohol—These substances may worsen tinnitus.
• Eating anti-inflammatory foods and a balanced diet may support ear health.

While these treatments may help some individuals, results vary. If tinnitus is persistent, consulting a healthcare provider is recommended. 

Conclusion

Tinnitus is a complex condition that can stem from various causes, including hearing loss, circulatory issues, and certain medications. While there is no universal cure, many treatment options—from sound therapy and cognitive behavioral therapy to lifestyle adjustments and alternative remedies—can help individuals manage symptoms effectively. Protecting your ears, maintaining good overall health, and seeking professional guidance when needed are key steps in preventing and managing tinnitus. If symptoms persist or worsen, consulting a healthcare provider is highly recommended.