CYCLANDELATE IN THE MANAGEMENT OF TINNITUS - A RANDOMIZED, PLACEBO-CONTROLLED STUDY

Cyclandelate is a vasodilating agent that, like papaverine, acts direc tly on the smooth muscles of blood vessels. The drug has been used pri marily as an adjunctive treatment for various peripheral vascular dise ases; some studies advocate its use for treating ischemic cerebrovascu lar disease. Early nonrandomized and uncontrolled studies suggest that cyclandelate is efficacious in treating tinnitus. Recent personal com munications regarding cyclandelate's effectiveness in treating tinnitu s prompted this study. Fifty-nine adult patients with constant tinnitu s for more than 1 year were randomly selected for this prospective, pl acebo-controlled, double-blind study with a treatment period of 3 mont hs. Audiometric testing with tinnitus pitch and loudness matching was performed before initiation of treatment and at the end of treatment, and frequent questionnaire evaluations were performed during the treat ment period. Four patients in the cyclandelate group and three in the placebo group reported a subjective reduction in the loudness of their tinnitus. Audiologic testing before and after treatment showed no sig nificant changes in tinnitus pitch or loudness. Although cyclandelate treatment was beneficial for some patients and the decrease in subject ive loudness scoring was significant for the cyclandelate group, the i mpact of its effect did not appear to warrant its continued use by tho se patients. A significant percentage of patients could not tolerate t he drug because of side effects.