Effectiveness of Over-The-Counter Treatments for Tinnitus Symptom Relief: A Systematic Review.
Level 1 - systematic review of randomized trials
Systematic review of randomized controlled trials
PubMed 41948711 · doi:10.1002/lio2.70398
What was done
A systematic review was conducted searching PubMed, Embase, Cochrane CENTRAL, ClinicalTrials.gov, and WHO ICTRP through March 2025. Nine randomized controlled trials (RCTs) evaluating oral over-the-counter (OTC) treatments (including melatonin, Ginkgo biloba, α-lipoic acid, açaí extract, and combination antioxidant/herbal formulations) across 390 adults were analyzed for pre- and posttreatment Tinnitus Handicap Inventory (THI) changes. A qualitative review was conducted instead of a meta-analysis due to clinical heterogeneity and incomplete reporting of variance data.
What was found
Several trials reported within-group reductions in THI scores for active treatments, but findings varied across agents, placebo responses were common, and most products were assessed in only a single small study. The abstract reports no pooled effect sizes or specific numerical values.
Why it matters
Despite widespread consumer use of OTC supplements for tinnitus, existing RCT evidence remains inadequate to support the clinical efficacy of any specific formulation.
Limits
The overall sample size was small (390 participants across nine studies). Marked variation in dosing, treatment duration, and study design prevented direct comparison, and missing variance data precluded quantitative meta-analysis.