Patients disabled by
tinnitus show a high prevalence of major depression. Furthermore,
tinnitus produces patterns of disability similar to those produced by major depression. To explore further this link between
tinnitus and depression, and to investigate the efficacy of treating depression in the treatment of
tinnitus, a single-blind, placebo-washout, nonrandomized pilot study of the
tricyclic antidepressant nortriptyline (hydrochloride) was undertaken in disabled
tinnitus patients who also met diagnostic criteria for major depression. Nineteen patients began the study, two responded to placebo, and two dropped out prior to completion. Fourteen considered their
tinnitus improved, and 12 chose to continue taking
nortriptyline after the study. Depression severity decreased, on the average, by 65% (p less than .0001).
Tinnitus loudness measured by audiometric matching decreased by a mean of 10 dB or 50% (p less than .02). Self-reports of
tinnitus loudness and severity, somatic and psychologic symptoms, and psychosocial dysfunction all showed significant improvement with treatment. These results suggest that what initially appears to be an irreversible otologic disability in these patients may be in large part a reversible psychiatric disability.