(836) Effectiveness of Over-the-Counter Treatments for Tinnitus Symptom Relief: A Systematic Review

Introduction: This systematic review evaluated whether over-the-counter (OTC) therapies are associated with changes in tinnitus-related handicap as measured by the Tinnitus Handicap Inventory (THI). Because of the nature of the THI score, observed changes should be interpreted as changes in handicap rather than direct physiological tinnitus reduction.

Methods: This review was conducted in accordance with PRISMA guidelines. The protocol was reviewed by Cooper University Health Care and deemed IRB-exempt due to exclusive use of de-identified, published data; it is available upon request. A comprehensive search of PubMed, Embase, CENTRAL, ClinicalTrials.gov, and WHO ICTRP was performed for records through March 2025. Of 1,448 records identified, 9 randomized controlled trials (RCTs) met inclusion criteria. Eligible studies enrolled adults with subjective tinnitus, evaluated orally administered OTC therapies versus placebo or routine care, and reported extractable pre- and post-treatment THI scores. Data extraction and risk-of-bias assessment were performed independently by four reviewers using a modified Cochrane tool. Due to substantial clinical and methodological heterogeneity and incomplete reporting of between-group variance, results were synthesized qualitatively.

Results: Nine RCTs comprising 10 treatment arms and 390 participants were included. Interventions included melatonin, Ginkgo biloba, and multi-component antioxidant or herbal formulations, with treatment durations ranging from 4 weeks to 6 months. Several interventions demonstrated within-group reductions in THI scores, while others showed minimal change. Placebo groups frequently improved, highlighting nonspecific and expectancy effects.

Conclusions: Although some OTC therapies were associated with improvements in THI scores within individual trials, current evidence is insufficient to support their clinical efficacy. No OTC treatment can be recommended as an evidence-based therapy for tinnitus. Well-powered RCTs with standardized outcome reporting are needed to guide clinical practice.