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Dramamine tinnitus: Review of Pharmacotherapy for Tinnitus

Review of Pharmacotherapy for Tinnitus

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Ménière’s Disease – Health Information Library

What is Ménière’s disease?

Ménière’s (say “men-YEERS”) disease is an inner ear problem that affects your hearing and balance. It normally occurs in only one ear at a time. But over time, it develops in the other ear in up to half of those who have it.

The disease usually occurs in people ages 40 to 60, but anyone can have it.

What causes it?

The cause of Ménière’s disease is not known. But it may be related to a fluid called endolymph in the inner ear. In people with Ménière’s disease, too much of this fluid builds up. This creates pressure in the parts of your inner ear that control balance. Experts aren’t sure why this fluid builds up. It may be that your body produces too much of the fluid. Or maybe the fluid doesn’t drain as it should from the inner ear. Or it may be both.

It’s hard to predict who will get Ménière’s disease. But your risk may be higher than normal if you have:

  • Another family member who has it.
  • An autoimmune disease, such as diabetes, lupus, or rheumatoid arthritis.
  • Had a head injury, especially if it involved your ear.
  • Had a viral infection of the inner ear.
  • Allergies.

What are the symptoms?

Ménière’s disease can cause symptoms that come on quickly and last from hours to days. During an attack, you may have:

  • Vertigo, the feeling that you or your surroundings are spinning. This may last from minutes to hours. It may be bad enough to cause nausea and vomiting.
  • Tinnitus, a low roaring, ringing, or hissing in your ear.
  • Hearing loss, which may be temporary or permanent.
  • A feeling of pressure or fullness in your ear.

Most people have repeated attacks over a period of years. Attacks usually happen more often during the first few years of the disease and then come less often after that.

In some cases, each attack damages the inner ear. Over time your inner ear may become so badly damaged that it no longer works as it should. Then the attacks may stop, but you may be left with:

  • Poor balance.
  • Permanent hearing loss.
  • Roaring or hissing in the affected ear.

A few people with Ménière’s disease have “drop attacks.” A drop attack is a sudden fall while you stand or walk. It occurs without warning. It may feel like you are suddenly being pushed to the ground. People who have these attacks don’t pass out, and they recover within seconds or minutes.

See a doctor right away if you think you have Ménière’s disease. Prompt diagnosis and treatment may reduce both the discomfort of the attacks and your risk of hearing loss.

How is it diagnosed?

To diagnose the disease, your doctor will do a physical exam that includes checking your ears, eyes, and nervous system. The doctor will also ask questions about your past health and your symptoms, such as:

  • How you feel when you have a vertigo attack.
  • How long an attack usually lasts.
  • Whether anything seems to trigger an attack, like changing your position.
  • Whether you have other symptoms along with vertigo, like hearing loss or nausea.

Your doctor may also do tests to confirm a diagnosis of Ménière’s. These tests may include:

  • Hearing tests, including one to find out if the nerve from the inner ear to the brain is working as it should.
  • A test called an electronystagmogram (ENG), which measures your eye movements. This can help the doctor find where the problem is that’s causing vertigo.
  • Imaging tests such as an MRI or CT scan of the head. These tests can find out if the symptoms are caused by a brain problem.

How is Ménière’s disease treated?

Ménière’s disease can’t be cured. But you can work with your doctor to find ways to decrease your symptoms and reduce how often you have attacks. Certain lifestyle changes like limiting sodium in your diet and reducing stress may help.


Your doctor may prescribe a diuretic medicine. Diuretics help rid your body of excess fluid, so they may help prevent the buildup of fluid in your inner ear. And that may mean you have fewer attacks.

Your doctor may also prescribe medicines to use when you have an attack, such as:

  • Medicines that reduce the vertigo. These include antihistamines such as dimenhydrinate (for example, Dramamine), sedatives such as diazepam (for example, Valium), and the scopolamine patch (Transderm Scop).
  • Medicines that reduce nausea and vomiting caused by vertigo. These are called antiemetics.

Other treatments

If symptoms are severe and don’t respond to medicine, your doctor may suggest another treatment. This may include a steroid injection into the inner ear to reduce the fluid or pressure in the inner ear. The goal is to get rid of your symptoms while saving as much of your hearing as possible.

In rare cases of severe, lasting Ménière’s disease, doctors may suggest a treatment to destroy the balance center in the inner ear (labyrinth), which can prevent vertigo. Options include:

  • Chemical ablation. During this procedure, an antibiotic (usually gentamicin) is injected into the inner ear to destroy the labyrinth.
  • Surgery to remove the labyrinth. This is called labyrinthectomy.

These treatments can cause permanent hearing loss, so they are usually done only as a last resort.

What can you do at home?

Ménière’s can be hard to manage and tough to live with. But there are some things you can do that may help reduce the number of attacks you have:

  • Eat low-salt foods. Salt makes your body hold on to excess fluid. If you eat less salt, you may have less buildup of fluid in the ear. So you may get vertigo less often.
  • Avoid caffeine, alcohol, and tobacco.
  • Try to reduce the stress in your life.

To reduce your symptoms when you have an attack:

  • Lie down and hold your head very still until the attack goes away.
  • Take your medicines for vertigo and nausea as soon as you can.

You can also take steps to help protect yourself when you have attacks:

  • Do exercises to improve your balance. This can reduce your risk of falling and hurting yourself or others.
  • Make changes to reduce your risk of injury during a vertigo attack. For example, install grab bars in your bathroom. Wear shoes with low heels and nonslip soles. And don’t drive during an attack.

Noise in the head and ears: causes, treatment

Many patients of general practitioners, cardiologists, neurologists complain about noise in the head. This non-specific symptom is called tinnitus – a person hears a sound, but without a noise source. Noise in the ears and in the head with the same frequency occurs in both men and women, both in young and in old age. Tinnitus reduces the quality of life and interferes with work and daily activities. The cause of noise in the head can be a serious illness or a slight deviation in health indicators. In any case, it is recommended to consult a doctor for diagnosis.

At the MedEx Personal Medicine Clinic, you can get an examination for noise in the head and get advice from an experienced general practitioner. We will help you get rid of tinnitus and restore the quality of life.

What is noise in the head like? noises. Normally, they are masked by external sounds. Noise and ringing in the head become audible when perception is heightened or when anomalous limits are reached.

Types of tinnitus:

  • Constant monotonous noise. The sound is not loud, without a strong ringing. Most patients get used to the monotonous tinnitus and stop paying attention to it until the accompanying symptoms appear;
  • Pulsating noise. The buzz in the head occurs paroxysmal, at the same time it can lay the ears. Pulsation appears when blood circulation is disturbed. The patient cannot cope with the attack on his own;
  • Ringing (whistling). This is one of the signs of hearing loss. It becomes difficult for a person to make out the words of other people, external sounds. To make out something because of the whistle, you have to listen.

Why is the noise in my head?

The most common cause of tinnitus is muscle and/or vascular disease. There is an opinion that as a result of damage, the cells of the hearing aid become hypersensitive. They react to the body’s own sounds and send an alarm signal to the brain. The first attacks of noises seem frightening and ominous, but gradually the patient gets used to them.

Symptoms can be differentiated by origin. If there is constant noise in the head, the pulsations of sound are synchronous with the heartbeat, then a vascular disease is likely. With an increase in blood pressure, the hum intensifies.

Muscle noises occur intermittently. The sounds are not related to the heartbeat and are more like crackling, clicking, machine-gun fire.

Other possible causes of persistent noise in the head:

  • depression, depression;
  • overwork;
  • Meniere’s disease;
  • hypertension;
  • cerebral aneurysm;
  • acoustic neuroma;
  • arrhythmia;
  • hormonal disorders;
  • iron deficiency anemia;
  • oncopathology;
  • osteochondrosis of the cervical spine;
  • consequences of taking medicines;
  • traumatic brain injury;
  • pathological changes in the auditory pathway, etc.

For some people, tinnitus can cause normal sleep deprivation or fatigue. To get rid of noise, it is necessary to eliminate its cause: how to relax and sleep. In old age, noise and pain in the head often occur due to the natural aging of the body. Doctors can help the patient adjust to the new condition in order to maintain quality of life and normal sleep.


If the noise in the head is accompanied by pain, dizziness, auditory hallucinations, other unpleasant sensations, it is necessary to go to the doctor as soon as possible. Such manifestations may indicate damage to the central nervous system.

Diagnosis for noise in the head

At the first appointment, the doctor asks the patient about the time of onset of symptoms, their nature and frequency. The doctor also collects information about the hereditary predisposition to diseases, the presence of provoking factors, for example, working in an enterprise with a high noise level, etc. Then the patient is examined, and basic neurological tests are performed.

Additional examinations are required to clarify the diagnosis:

  • audiometry – measuring the level of auditory perception;
  • sound level – determination of the nature of sounds;
  • angiography of cerebral vessels;
  • CT or MRI according to indications in difficult cases;
  • Doppler echocardiography.

Based on the results of the examination, the doctor establishes a diagnosis and prescribes treatment. If no abnormalities are found, the patient is advised to take a leave of absence from work and restore their own peace of mind.

Lunyushkin Igor Nikolaevich

Find time for yourself!

Vertebrologist, chiropractor

Experience 38 years

Treatment for head noise

Therapy depends on the cause of tinnitus. For example, noise in the head with osteochondrosis requires complex treatment with non-steroidal anti-inflammatory drugs, muscle relaxants, and vitamins. The patient is prescribed a course of massage, physiotherapy and exercise therapy.

If noise and congestion are caused by otitis media, diseases of the hearing organs, an otolaryngologist will treat the person. The patient will be prescribed antibiotics, drops.

Noise in the ears and in the head with pressure is the competence of a cardiologist. The doctor must determine the cause of hypertension and select medications that will help normalize the patient’s condition. To get rid of tinnitus, you need to control your blood pressure.

In general, the treatment will be complex, including conservative therapy, physical and psychotherapeutic techniques. In severe cases, surgery is required.

To relieve symptoms, your doctor may prescribe:

  • medicines: antidepressants, vitamins, nootropics, vasoactive drugs, antihistamines, vasodilators, anesthetics, diuretics;
  • physiotherapy: electrophoresis, iontophoresis, phototherapy, reflexology;
  • non-traditional methods of treatment: acupuncture, aromatherapy, hirudotherapy;
  • physical activities: classes with an exercise therapy instructor, swimming, hiking in the fresh air.

It should be understood that it is not always possible to get rid of the noise in the head completely. The doctor can ease the symptoms so that the patient can return to their usual way of life. To improve falling asleep, you can constantly use audio maskers – turn on classical music or sounds of wildlife. Some patients respond well to the sound of rain, birdsong.

Make an appointment at the MedEx clinic so that the noise in your head does not prevent you from enjoying life. Our doctors treat with methods with proven effectiveness, according to individually drawn up schemes, advise in detail on recovery and prevention of relapses.


  • A. I. Melekhin. The use of cognitive-behavioral psychotherapy in otolaryngology on the example of patients with tinnitus – Scientific article, II International Conference on Counseling Psychology and Psychotherapy, dedicated to the memory of Fedor Efimovich Vasilyuk: collection of materials, 2020
  • Ya. L. Shcherbakova, V. E. Kuzovkov, S. M. Megrelishvili, A. V. Shaporova. Methods for assessing the effectiveness of therapy in patients with tinnitus – Journal of Russian Otolaryngology, 2013

classification, causes of tinnitus, methods of treatment

Tinnitus (tinnitus) is a condition when a person hears various sounds, but their obvious source is absent. Patients describe the sensations in different ways: as a low rumble, similar to the operation of an engine, or a monotonous constant noise. Often they hear a squeak or ring. Some compare the auditory sensation to crackling or rumbling. Noise occurs suddenly, and it is not always possible to trace the connection between the impact of any external factors and its appearance. It lasts from several minutes to several days, and sometimes even weeks. This significantly reduces performance and affects the emotional background, up to the onset of depression.

Tinnitus can be both unilateral and bilateral, accompanied by intense pain in the temples and ear, hearing loss, balance disorders and dizziness. Sometimes it is so strong that it completely drowns out the sounds of the surrounding world.


According to the sound characteristics, the noise is divided into tonal (smooth sound of the same frequency, such as rumble, whistle, ringing) and non-tonal (rumble, crackle, clicks). According to the duration, tinnitus is divided into acute (up to 3 months), subacute (3-12 months), chronic (more than 1 year). In clinical practice, it is classified by reason of appearance:

  • Subjective. Often due to prolonged exposure to loud sound on the auditory analyzer. Extraneous noises are heard only by the patient, this prevents him from concentrating on the conversation, doing the work.
  • Neurological. Caused by damage to nerve receptors in the inner ear, such as Meniere’s disease. A strong hum is usually accompanied by dizziness.
  • Somatic. Associated with damage to any organ, pathological impulses from which irritate the auditory analyzer. May be provoked by touch and movement.
  • Objective. The disorder is due to the pathology of the muscular system, deformation of the vessels of the ear. The doctor may hear a pulsating sound when using the stethoscope.

To assess discomfort, Soldatov’s classification is used, dividing noise according to severity:

  1. A person adapts to extraneous sounds, working capacity is maintained.
  2. Intense noise appears during the night.
  3. A strong constant hum interferes with daily activities.
  4. The functionality is completely lost.

Causes of tinnitus

  • Acoustic injury.

The condition can be triggered by a single exposure to very high volume (rock concerts, fireworks, gunshots) or continuous exposure (loud music on headphones, work in sewing shops and factories). With an acute injury, hearing temporarily disappears, against the background of this, a squeak in the ears or a monotonous ringing occurs. Sometimes disturbed by dizziness, throbbing severe pain in the temples. With constant exposure to sound stimuli, a gradual increase in symptoms is noted. First, there is a short-term noise after being in rooms with loud sounds. Then the hum in the ears is accompanied by hearing loss and becomes permanent.

  • Age-related changes.

Every fifth among people aged 55-65 periodically notes the occurrence of extraneous sounds, after 65 years, up to 40% of people suffer from ringing and buzzing in the ears. The most common complaint is bilateral noise, very quiet at first but tends to build up. Due to its increase at night, patients often suffer from insomnia. In older people, these phenomena are due to degenerative changes in the inner ear.

  • Hypertension.

Tinnitus is typical for patients suffering from high blood pressure, the intensity of auditory sensations is affected by the BP indicator. The reason for the occurrence of extraneous sounds is the turbulent movement of blood through the narrowed vessels. Usually, hypertensive patients hear a slight hum that appears against the backdrop of a headache. Its amplification, accompanied by flickering of “flies”, nausea, may indicate a hypertensive crisis.

  • Pathological processes in the ear.

Noise may indicate damage to the auditory analyzer. After the relief of the underlying pathology, the ringing and hum cease to disturb. With some lesions, tinnitus becomes permanent (otitis media, otitis externa, eustachitis, foreign bodies, sulfur plugs, otosclerosis).

  • Vascular disorders.

Tinnitus most often occurs with atherosclerosis – lipid plaques on the walls of the vessels of the inner ear interfere with the normal movement of blood, which is felt as a pulsating noise. In most patients, the hum is more pronounced on one side.

  • Tumors.

Noise is characteristic of acoustic neuroma, a benign formation. The first symptom of a neoplasm is unilateral tinnitus. With the development of pathology, hearing on the side of the lesion worsens, sound sensations increase. Unilateral pulsating noise in combination with asymmetry of the palpebral fissure, swallowing disorder is a sign of a glomus tumor of the ear.

  • Cervical osteochondrosis.

A buzz or ringing in the ears in case of problems with the spine occurs when the head is turned or tilted sharply, or if you stay in an uncomfortable position for a long time. The reason is the squeezing of the vessels going from the neck to the ear and brain.

  • Traumatic brain injury.

Mild head bruising accompanied by short ringing or tinnitus without significant discomfort. With more serious damage, unusual auditory sensations occur against the background of severe headaches, nausea. The symptom may appear several days after the injury.

  • Complications of pharmacotherapy.

Tinnitus may develop 7 to 14 days after starting treatment for serious bacterial infections due to the ototoxic effects of the drugs. This side effect is provoked by antibiotics (macrolides, tetracyclines), diuretics (furosemide, hydrochlorothiazide), high doses of NSAIDs (indomethacin, diclofenac), tranquilizers (Phenazepam, Tranxen).


When tinnitus occurs, the patient is referred to an otolaryngologist to identify otogenic causes. The examination uses laboratory and instrumental methods. The most informative of them:

  • Inspection of the ear canal. Otoscopy eliminates tympanic membrane rupture, inflammation of the outer and middle ear.
  • Audiometry. With the help of special devices that generate sounds of a given frequency, hearing impairments are detected. Tuning fork tests make it possible to differentiate between the pathologies of the inner and middle ear.
  • X-ray examinations. Often, tinnitus is provoked by neurological problems, so patients are prescribed x-rays of the bones of the skull. In patients with osteochondrosis, the spine is examined. To visualize formations and structural disorders of the brain, MRI and CT of the head are prescribed.
  • Angiography. If there is a suspicion of an aneurysm or atherosclerotic lesion of the cerebral vessels, an angiogram with contrast is performed to visualize the structure of the vascular bed and establish the localization of pathological changes.

Laboratory methods are used as auxiliary methods – general and biochemical blood tests, serological reactions (PCR, RIF, ELISA). With inflammation, accompanied by discharge from the ear, bacteriological culture is performed. In difficult cases, to identify the cause of tinnitus, consultations of various specialists (oncologist, neurologist) are required, sometimes a psychiatric examination is indicated.

Doctor’s expert opinion

Sokolova Elena Igorevna

Neurologist, vestibulologist

When to contact a specialist and which one?

Often, tinnitus is a sign of a disease, the treatment of which should be started as soon as possible. It is urgent to consult a doctor if symptoms such as hearing loss, severe headaches, discomfort in the heart muscle area, nausea, vomiting, dizziness, and impaired coordination join tinnitus. With bilateral noise, you need to make an appointment with a general practitioner or a neurologist, with one-sided noise, you should start with an otorhinolaryngologist.


Complete elimination of noise is possible only if the underlying disease is eliminated, so a visit to the doctor should not be postponed. To initially reduce discomfort, sedative herbal preparations, herbal teas are indicated. Ear massage can help.

Conservative therapy

The treatment regimen is selected depending on the underlying disease and concomitant pathology. A prerequisite is the elimination of the provoking factor (change of work, refusal of loud music). Treatment includes antibiotics, angioprotectors, antihistamines, and anti-inflammatory drugs. For symptomatic treatment of noise, sedatives, antidepressants, and tranquilizers are used.

Experimental treatment

Tinnitus retraining therapy (TRT) is a type of cognitive behavioral therapy. During an individual lesson, a person is taught techniques for switching attention, methods of relaxation. One of the components of the treatment is individual sound therapy (the rustle of leaves, the sound of rain, the splashing of waves). Gradually, the brain learns to block these sounds, which helps to reduce the perception of pathological noise.

Surgical treatment

If purulent inflammation is the cause of extraneous sounds, the tympanic cavity is opened and drained. Detected tumors of the auditory analyzer are removed with mandatory cytomorphological examination. For the treatment of malignant neoplasms, surgery is prescribed in conjunction with radiation and chemotherapy. In aneurysms, the affected vessel is clipped.

EuroCityClinic uses modern techniques to eliminate tinnitus. Experienced otorhinolaryngologists will identify the cause of the pathology and develop an effective treatment regimen. We will make every effort to improve the patient’s quality of life.


Drug therapy includes drugs that improve blood circulation and oxygen excretion (derivatives of ginkgo biloba, vinpocetine), histaminergic drugs (betahistine dihydrochloride), anticonvulsants and vitamins of group B. If the noise is caused by neuropsychiatric factors, tranquilizers are prescribed. All medicines are taken only as prescribed by a doctor.