Optimal Dosing of Nortriptyline-Topiramate and Verapamil-Paroxetine Combinations in Tinnitus Treatment
Abstract
OBJECTIVE: To determine effective dose strategies for nortriptyline-topiramate (NT) and verapamil-paroxetine (VP) combinations for tinnitus treatment.
METHODS: This secondary analysis examined data from an 8-week, randomized, double-blind, placebo-controlled trial (RCT) evaluating treatment outcomes in 41 patients. Tinnitus Functional Index (TFI) scores were used as the primary outcome measure, administered at baseline, Week 4, and Week 8 to assess achievement of minimal clinically important differences (MCID) of 13-point reduction. Descriptive statistics were employed to characterize treatment responses and assess dose-response relationships.
RESULTS: In the NT group (n = 19), 42% of the participants achieved a reduction in TFI scores meeting MCID with a mean dose of 44 ± 12 mg nortriptyline plus 59 ± 16 mg topiramate, all showing greater than 15% improvement. In the VP group (n = 22), 41% reached MCID with a mean of 207 ± 36 mg verapamil plus 28 ± 5 mg paroxetine. Of these, 88.9% showed at least a 15% improvement in TFI. Early responders who achieved MCID by the midpoint of the trial required continued dose escalations due to limited improvement in weekly VAS scores afterward. However, subsequent TFI changes were not statistically significant.
CONCLUSIONS: Both NT and VP regimens effectively reduce tinnitus severity in approximately half of the patients at moderate doses within 8 weeks. However, long-term effects may not have been fully captured, particularly among late…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 41 participants or records.
Read the paper
Related studies
- Calcium Ions in the Physiology and Pathology of the Central Nervous System
- AI-powered in silico twins: redefining precision medicine through simulation, personalization, and predictive healthcare
- In silico functional, structural and pathogenicity analysis of missense single nucleotide polymorphisms in human MCM6 gene
- In Silico drug repurposing pipeline using deep learning and structure based approaches in epilepsy
- Targeting serotonin receptors with phytochemicals – an in-silico study
- In silico exploration of anti-prostate cancer compounds from differential expressed genes
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.