I have not had hyperacusis in a couple of years, but my severe tinnitus was also getting progressively worse. So far this has been the only thing that has worked to actually lower the noise. I still hear it 24/7 but its much quieter and for me that's like a cure. I am on 25mg. Studies say that some folks see greater relief from 50mg. Some people get relief from low dose 1mg to 4.5mg.