Review Article

Does Melatonin Have Therapeutic Use in Tinnitus?

Authors: Leah Merrick, RN, Dima Youssef, MD, Michelle Tanner, MS IV, Alan N. Peiris, MD, PhD

Abstract

Melatonin, a hormone produced by the pineal gland, may be a promising treatment option for tinnitus. The primary functions of this hormone are believed to be the initiation and maintenance of sleep because its secretions coincide with circadian rhythms. Some
investigators have noted that melatonin may alleviate subjective symptoms of tinnitus. Moreover, melatonin may have properties protective against ototoxic drugs such as amikacin, gentamicin, or cancer therapeutic agents that are dose dependent. In vitro, melatonin has demonstrated antioxidative properties and it has been postulated that these antioxidative properties contribute to the alleviation of tinnitus. Melatonin levels used to obtain these findings in vitro, however, are at supraphysiologic levels; therefore, it is more likely that the benefits from taking supplemental melatonin occur from minimal antioxidative properties, sleep enhancement, or other potential methods of action that are not yet understood. Melatonin offers minimal risk of toxicity with modest daily doses such as 1 to 3 mg, as well as a low cost and favorable adverse effect profile for older adults. In addition to potential benefits in the treatment of tinnitus, melatonin also may have beneficial neurogenerative properties. We recommend that melatonin be considered for use in patients with significant tinnitus.

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Ciorba A, Bianchini C, Pelucchi S, et al. The impact of hearing loss on the quality of life of elderly adults. Clin Interv Aging 2012;7:159-163.
 
2. Parham K, Mckinnon BJ, Eibling D, et al. Challenges and opportunities in presbycusis. Otolaryngol Head Neck Surg 2011;144:491-495.
 
3. Veterans Benefits Administration. Annual benefits reports. www.vba.va.gov/reports/abr/index.asp. Accessed April 22, 2014.
 
4. Crummer RW, Hassan GA. Diagnostic approach to tinnitus. Am Fam Physician 2004;69:120-126.
 
5. Engineer N, Moller AR, Kilgard MP. Directing neural plasticity to understand and treat tinnitus. Hear Res 2013;295:58-66.
 
6. Shargorodsky J, Curhan GC, Farwell WR. Prevalence and characteristics of tinnitus among US adults. Am J Med 2010;123:711-718.
 
7. Lopez-Gonzalez MA, Guerrero JM, Torronteras R, et al. Ototoxicity caused by aminoglycosides is ameliorated by melatonin without interfering with the antibiotic capacity of the drugs. J Pineal Res 2000;28:26-33.
 
8. Lasisi AO, Fehintola FA. Correlation between plasma levels of radical scavengers and hearing threshold among elderly subjects with age-related hearing loss. Acta Otolaryngol 2011;131:1160-1164.
 
9. Esposito E, Cuzzocrea S. Antiinflammatory activity of melatonin in central nervous system. Curr Neuropharmacol 2010;8:228-242.
 
10. Waldhauser F, Weiszenbacher G, Frisch H, et al. Fall in nocturnal serum melatonin during prepuberty and pubescence. Lancet 1984;1:362-365.
 
11. Lynch HJ, Wurtman RJ, Moskowitz MA, et al. Daily rhythm in human urinary melatonin. Science 1975;187:169-171.
 
12. Reiter RJ, Tan DX, Mayo JC, et al. Melatonin as an antioxidant: biochemical mechanisms and pathophysiological implications in humans. Acta Biochim Pol 2003;50:1129-1146.
 
13. Pirodda A, Raimondi MC, Ferri GG. Exploring the reasons why melatonin can improve tinnitus. Med Hypotheses 2010;75:190-191.
 
14. Reiter R, Tang L, Garcia JJ, et al. Pharmacological actions of melatonin in oxygen radical pathophysiology. Life Sci 1997;60:2255-2271.
 
15. Stouffer JL, Tyler RS. Characterization of tinnitus by tinnitus patients. J Speech Hear Disord 1990;55:439-453.
 
16. Langguth B, Elgoyhen AB. Current pharmacological treatments for tinnitus. Expert Opin Pharmacother 2012;13:2495-2509.
 
17. Hesser H, Weise C, Westin VZ, et al. A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress. Clin Psychol Rev 2011;31:545-553.
 
18. Hoare DJ, Kowalkowski VL, Knag S, et al. Systematic review and meta-analyses of randomized controlled trials examining tinnitus management. Laryngoscope 2011;121:15555-15564.
 
19. Hesser H, Gustafsson T, Lunden C, et al. A randomized controlled trial of Internet-delivered cognitive-behavior therapy and acceptance and commitment therapy in the treatment of tinnitus. J Consult Clin Psychol 2012;80:649-661.
 
20. House JW, Brackmann DE. Tinnitus: surgical treatment. Ciba Found Symp 1981;85:204-216.
 
21. De Ridder D, Vanneste S, Engineer ND, et al. Safety and efficacy of vagus nerve stimulation paired with tones for the treatment of tinnitus: a case series. Neuromodulation 2014;17:170-179.
 
22. Lasisi AO, Fehintola FA, Lasisi TJ. The role of plasma melatonin and vitamins C and B12 in the development of idiopathic tinnitus in the elderly. Ghana Med J 2012;46:152-157.
 
23. Megwalu UC, Finnell JE, Piccirillo JF. The effects of melatonin on tinnitus and sleep. Otolaryngol Head Neck Surg 2006;134:210-213.
 
24. Neri G, Baffa C, De Stefano A, et al. Management of tinnitus: oral treatment with melatonin and sulodexide. J Biol Regul Homeost Agents 2009;23:103-110.
 
25. Hurtuk A, Dome C, Hollman CH, et al. Melatonin: can it stop the ringing? Ann Otol Rhinol Laryngol 2011;120:433-440.
 
26. Rosenberg SI, Silverstein H, Rowan PT, et al. Effect of melatonin on tinnitus. Laryngoscope 1998;108:305-310.
 
27. Lopez-Gonzalez MA, Santiago AM, Esteban-Ortega F. Sulpiride and melatonin decrease tinnitus perception modulating the auditolimbic dopaminergic pathway. J Otolaryngol 2007;36:213-219.
 
28. Reiter RJ, Tan DX, Korkmaz A, et al. Drug-mediated ototoxicity and tinnitus: alleviation with melatonin. J Physiol Pharmacol 2011;62:151-157.
 
29. Ye LF, Tao ZZ, Hua QQ, et al. Protective effect of melatonin against gentamicin ototoxicity. J Laryngol Otol 2009;123:598-602.
 
30. Erdem T, Ozturan O, Iraz M, et al. Dose-dependent dual effect of melatonin on ototoxicity induced by amikacin in adult rats. Eur Arch Otorhinolaryngol 2005;262:314-321.
 
31. Buscemi N, Vandermeer B, Hooton N, et al. The efficacy and safety of exogenous melatonin for primary sleep disorders. A meta-analysis. J Gen Intern Med 2005;20:1151-1158.
 
32. Meng T, Zheng ZH, Liu TT, et al. Contralateral retinal dopamine decrease and melatonin increase in progression of hemiparkinsonium rat. Neurochem Res 2012;37:1050-1056.
 
33. Duell PB, Wheaton DL, Shultz A, et al. Inhibition of LDL oxidation by melatonin requires supraphysiologic concentrations. Clin Chem 1998;44:1931-1936.
 
34. Gerdin MJ, Masana MI, Dubocovich ML. Melatonin-mediated regulation of human MT(1) melatonin receptors expressed in mammalian cells. Biochem Pharmacol 2004;67:2023-2030.
 
35. Gerdin MJ, Masana MI, Rivera-Bermudez MA, et al. Melatonin desensitizes endogenous MT2 melatonin receptors in the rat suprachiasmatic nucleus: relevance for defining the periods of sensitivity of the mammalian circadian clock to melatonin. FASEB J 2004;18:1646-1656.
 
36. Dollins AB, Zhdanova IV, Wurtman RJ, et al. Effect of inducing nocturnal serum melatonin concentrations in daytime on sleep, mood, body temperature, and performance. Proc Natl Acad Sci U S A 1994;91:1824-1828.
 
37. Gooneratne N, Edwards AY, Zhou C, et al. Melatonin pharmacokinetics following two different oral surge-sustained release doses in older adults. J Pineal Res 2012;52:437-445.
 
38. Kostoglou-Athanassiou I. Therapeutic applications of melatonin. Ther Adv Endocrinol Metab 2013;4:13-24.
 
39. Olcese JM, Cao C, Mori T, et al. Protection against cognitive deficits and markers of neurodegeneration by long-term oral administration of melatonin in a transgenic model of Alzheimer disease. J Pineal Res 2009;47:82-96.