Clinical Trial of Acamprosate for Tinnitus

[Tinnitus Talk]

Tinnitus Talk submitted a new resource:

Clinical Trial of Acamprosate for Tinnitus (version 1.0) - The first phase is an open-label screening study to identify subjects responding to acamprosate.

The objective of this project is to determine whether acamprosate is more effective at providing relief for tinnitus than a placebo.

Acamprosate has been suggested to be effective in reducing tinnitus annoyance in a preliminary study. Study evidence indicates that tinnitus is related to increased excitatory spontaneous brain activities. Acamprosate may help restore the excitatory/inhibitory balance in the brain and thus reduce tinnitus.

The current study includes three phases. The first...

Read more about this resource...

 

[1MW]

Have anyone tested acamprosate?
Especially those that have benzos related tinnitus.

 

[Christian78]

I have got a big box of this medicine and tested it and it did nothing FOR ME! Everyone is different (I use/d benzos)

 

[Aziz Khan]

Have anyone tested acamprosate?
Especially those that have benzos related tinnitus.

What is benzo related?

 

[1MW]

Benzos related is T induced from benzodiazepine drugs.
Benzos induce T more easily in people that has some form of hearing loss but no T.
Also benzodiazepines withdrawal cause severe hyperacusis T and distorted hearing.
Benzodiazepines induce high frequency T.
Also people with genetic deficiency in benzodiazepines receptors without taking never benzos are more to develop T.
In general benzos induced T tends to be severe because in unmaskeable.
Benzos are life killer drugs with severe withrawal symptoms.
In short term use at specific situations can save lifes

 

[Danny Boy]

I'll try to get some to see if it works for me..Could be a time limit, like AM-101? Maybe within the first year.

 

[Mark662]

I tried Campral a long time ago. It did nothing for my tinnitus, and made me very depressed. It caved my brain in.

The trial was flawed and the resuls should never have been released, as subsequent trials showed the drug was totally ineffective for tinnitus

No doubt it boosted sales of Campral for a while. It was the ultimate Red Herring.

 

[Danny Boy]

I tried Campral a long time ago. It did nothing for my tinnitus, and made me very depressed. It caved my brain in.

The trial was flawed and the resuls should never have been released, as subsequent trials showed the drug was totally ineffective for tinnitus

No doubt it boosted sales of Campral for a while. It was the ultimate Red Herring.

I did hear of some people finding their t to be lower due to campral, one ENT said that 4 out of 20 patients found relief, so not as high as the study, but the potential is there.

 

[Mark662]

I did hear of some people finding their t to be lower due to campral, one ENT said that 4 out of 20 patients found relief, so not as high as the study, but the potential is there.

4 out of 20 could be the sort of response with a placebo. I certainly wouldn't recommend trying it. The internet isn't showing any numbers having success with it either

 

[Danny Boy]

4 out of 20 could be the sort of response with a placebo. I certainly wouldn't recommend trying it. The internet isn't showing any numbers having success with it either

Well, in that case we can say trobalt is an placebo effect. We could say any med is a placebo effect.

 

[Mark662]

I don't believe Trobalt's effect is placebo. At least it is a drug that is targeting the area of the brain that appears to be a hot spot for tinnitus, unlike Campral. If I could get my hands on Trobalt for a reasonable cost, I would be trying it

 

[Danny Boy]

I don't believe Trobalt's effect is placebo. At least it is a drug that is targeting the area of the brain that appears to be a hot spot for tinnitus, unlike Campral. If I could get my hands on Trobalt for a reasonable cost, I would be trying it

Prescription Medication

If his patients have crossed his "magic line" of either affecting activities of daily living or interfering with sleep, and have not responded to the previous therapies, he offers prescription medications.

1 – Xanax. He states that patients must use the real medication, not generics. He generally prescribes 0.5 mg, three times daily, for 4 months then conducts a follow-up appointment. This treatment helps, but does not cure, 78% of patients.

2 – Baclofen plus Klonopin. He prescribes 10 mg Baclofen, three times daily, plus 1 mg Klonopin at bedtime. He finds that neither alone is as effective as both together. Baclofen is a muscle relaxant and an anti-spastic agent. It is also a selective GABA receptor drug and has been used in tinnitus trials with some success. Klonopin is a benzodiazepine derived anti-convulsant and anti-anxiety medication.

3 – Neurontin or Lyrica. These are anti-epilepsy medications that work by increasing GABA uptake in the brain. GABA is the primary inhibitory neurotransmitter in the brain and helps decrease electrical activity. Increased electrical activity can lead to seizure, tinnitus and many other neurodegenerative conditions.

Dr. Seidman is not a big fan of prescribing Neurontin and Lyrica because they require liver function tests and so he frequently sends these patients to a neurologist. When he does prescribe Neurontin, he starts with a low dose of 300 mg, three times daily, and has gone up to as high as 1200 mg, three times daily. He has seen success at both the low doses and higher dosage.

4 – Campral. This is a medication that has recently been approved by the FDA for alcohol dependence. A clinical study in Brazil showed it reduced tinnitus in most patients. The study was very small and flawed in many respects but it still holds promise. Researchers surmise that it may act as a glutamate antagonist, a potential contributor to tinnitus. A discussion of glutamate antagonists and excitotoxins can be seen in our Tinnitus Library.

Dr. Seidman has treated about 20 tinnitus patients with Campral and it has helped 3-4. He will use it if the patient requests it.

5 – Memantine. This is another glutamate antagonist. Dr. Seidman says he has a 15% response rate.

 

[Mark662]

Prescription Medication

If his patients have crossed his "magic line" of either affecting activities of daily living or interfering with sleep, and have not responded to the previous therapies, he offers prescription medications.

1 – Xanax. He states that patients must use the real medication, not generics. He generally prescribes 0.5 mg, three times daily, for 4 months then conducts a follow-up appointment. This treatment helps, but does not cure, 78% of patients.

2 – Baclofen plus Klonopin. He prescribes 10 mg Baclofen, three times daily, plus 1 mg Klonopin at bedtime. He finds that neither alone is as effective as both together. Baclofen is a muscle relaxant and an anti-spastic agent. It is also a selective GABA receptor drug and has been used in tinnitus trials with some success. Klonopin is a benzodiazepine derived anti-convulsant and anti-anxiety medication.

3 – Neurontin or Lyrica. These are anti-epilepsy medications that work by increasing GABA uptake in the brain. GABA is the primary inhibitory neurotransmitter in the brain and helps decrease electrical activity. Increased electrical activity can lead to seizure, tinnitus and many other neurodegenerative conditions.

Dr. Seidman is not a big fan of prescribing Neurontin and Lyrica because they require liver function tests and so he frequently sends these patients to a neurologist. When he does prescribe Neurontin, he starts with a low dose of 300 mg, three times daily, and has gone up to as high as 1200 mg, three times daily. He has seen success at both the low doses and higher dosage.

4 – Campral. This is a medication that has recently been approved by the FDA for alcohol dependence. A clinical study in Brazil showed it reduced tinnitus in most patients. The study was very small and flawed in many respects but it still holds promise. Researchers surmise that it may act as a glutamate antagonist, a potential contributor to tinnitus. A discussion of glutamate antagonists and excitotoxins can be seen in our Tinnitus Library.

Dr. Seidman has treated about 20 tinnitus patients with Campral and it has helped 3-4. He will use it if the patient requests it.

5 – Memantine. This is another glutamate antagonist. Dr. Seidman says he has a 15% response rate.

Neurontin (Gabapentin) is another drug that is banded about for t and clinically proven to be ineffective. Yes, I have tried that too.

Xanax was effective when I took it, but soon built up a tolerance and was reluctant to increase the dosage.

I think the scattergun approach by Dr Seidman and the drugs used are rather dated. Research has moved on.

Everyone wants an existing off label drug treatment to be effective. It has yet to be discovered.

 

[Danny Boy]

Neurontin (Gabapentin) is another drug that is banded about for t and clinically proven to be ineffective. Yes, I have tried that too.

Xanax was effective when I took it, but soon built up a tolerance and was reluctant to increase the dosage.

I think the scattergun approach by Dr Seidman and the drugs used are rather dated. Research has moved on.

Everyone wants an existing off label drug treatment to be effective. It has yet to be discovered.

Well, I don't know, but we don't know if it can work for others. That's why I don't rule out anything.

 

[Mark662]

By all means, try everything and anything. I have done so for 25 years and nothing, apart from Xanax, has had any effect whatsoever, that is why medical science does not have the answer. It is one of the most complicated conditions to cure or even alleviate.

 

[Danny Boy]

By all means, try everything and anything. I have done so for 25 years and nothing, apart from Xanax, has had any effect whatsoever, that is why medical science does not have the answer. It is one of the most complicated conditions to cure or even alleviate.

Get ye self some trobalt!

 

[Mark662]

Get ye self some trobalt!

I need a sympathetic GP

 

[Danny Boy]

I need a sympathetic GP

Yeah, don't we all? They are just scared they'd be struck off...

Physicians in the United Kingdom can prescribe medications off-label. According to the British General Medical Council, off-label prescriptions must better serve patient needs than alternatives and must be supported by evidence or experience to demonstrate safety and efficacy.

In the United States, no law prohibits a physician or other healthcare practitioner from prescribing an approved medication for other uses than their specific FDA-approved indications.

So technically trobalt can serve as treatment for tinnitus than other drugs, therefore should be prescribed off label. There's loads of evidence trobalt works and is the best tinnitus treatment out there, so just keep going on and fight for it! Never give up I say. I made the argument that amitriptyline is used off label for sleep and tinnitus, but isn't licensed so technically they can prescribe trobalt off label.

 

[Mark662]

Yeah, don't we all? They are just scared they'd be struck off...

Physicians in the United Kingdom can prescribe medications off-label. According to the British General Medical Council, off-label prescriptions must better serve patient needs than alternatives and must be supported by evidence or experience to demonstrate safety and efficacy.

In the United States, no law prohibits a physician or other healthcare practitioner from prescribing an approved medication for other uses than their specific FDA-approved indications.

So technically trobalt can serve as treatment for tinnitus than other drugs, therefore should be prescribed off label. There's loads of evidence trobalt works and is the best tinnitus treatment out there, so just keep going on and fight for it! Never give up I say. I made the argument that amitriptyline is used off label for sleep and tinnitus, but isn't licensed so technically they can prescribe trobalt off label.

Did you get your GP to prescribe Trobalt?

 

[Christian78]

Prescription Medication

If his patients have crossed his "magic line" of either affecting activities of daily living or interfering with sleep, and have not responded to the previous therapies, he offers prescription medications.

1 – Xanax. He states that patients must use the real medication, not generics. He generally prescribes 0.5 mg, three times daily, for 4 months then conducts a follow-up appointment. This treatment helps, but does not cure, 78% of patients.

2 – Baclofen plus Klonopin. He prescribes 10 mg Baclofen, three times daily, plus 1 mg Klonopin at bedtime. He finds that neither alone is as effective as both together. Baclofen is a muscle relaxant and an anti-spastic agent. It is also a selective GABA receptor drug and has been used in tinnitus trials with some success. Klonopin is a benzodiazepine derived anti-convulsant and anti-anxiety medication.

3 – Neurontin or Lyrica. These are anti-epilepsy medications that work by increasing GABA uptake in the brain. GABA is the primary inhibitory neurotransmitter in the brain and helps decrease electrical activity. Increased electrical activity can lead to seizure, tinnitus and many other neurodegenerative conditions.

Dr. Seidman is not a big fan of prescribing Neurontin and Lyrica because they require liver function tests and so he frequently sends these patients to a neurologist. When he does prescribe Neurontin, he starts with a low dose of 300 mg, three times daily, and has gone up to as high as 1200 mg, three times daily. He has seen success at both the low doses and higher dosage.

4 – Campral. This is a medication that has recently been approved by the FDA for alcohol dependence. A clinical study in Brazil showed it reduced tinnitus in most patients. The study was very small and flawed in many respects but it still holds promise. Researchers surmise that it may act as a glutamate antagonist, a potential contributor to tinnitus. A discussion of glutamate antagonists and excitotoxins can be seen in our Tinnitus Library.

Dr. Seidman has treated about 20 tinnitus patients with Campral and it has helped 3-4. He will use it if the patient requests it.

5 – Memantine. This is another glutamate antagonist. Dr. Seidman says he has a 15% response rate.

1. addictive and loses effect after 3 months dosage must be increased

2. same benzo loses effect after 3 months dosage must be increased

3. they use lyrica it is medicine for neuro pains but it kills brain fast anyway the one that caused me worsening of tinnitus 200% may 2014.
4.I used Campral it did not help ME, but we see it someone else try it, I am say to throw 150 pills in garbage

5 i don't know anything about this thing Memantine

 

[Danny Boy]

Did you get your GP to prescribe Trobalt?

She said, she'll call me back next week, so they are considering it.

 

[Danny Boy]

1. addictive and loses effect after 3 months dosage must be increased

2. same benzo loses effect after 3 months dosage must be increased

3. they use lyrica it is medicine for neuro pains but it kills brain fast anyway the one that caused me worsening of tinnitus 200% may 2014.
4.I used Campral it did not help ME, but we see it someone else try it, I am say to throw 150 pills in garbage

5 i don't know anything about this thing Memantine

Sorry to hear about that buddy.

 

[Mark662]

She said, she'll call me back next week, so they are considering it.

But you had relief from 3 x 400mg Trobalt, obtained from another source? am I right?

 

[Danny Boy]

But you had relief from 3 x 400mg Trobalt, obtained from another source? am I right?

Yep.

 

[Frédéric]

Just in order to feed the thread, see the pdf file for intermediate results.
See also: https://www.tinnitustalk.com/threads/acamprosate-campral.394/#post-2640

 

[Frédéric]

https://clinicaltrials.gov/ct2/show/NCT00596531
Status: this study has been completed.

I sent an e-mail 3 days ago to William Martin, the contact of this trial. He kindly replied today:

Frederic,
I'm very sorry to read that you have tinnitus. I know that it is a horrible condition. I have been working with individuals having tinnitus since 1986 so I understand your desire to find help.
The study we conducted on the efficacy of acamprosate for tinnitus was the most carefully conducted clinical trial for a tinnitus treatment ever performed. We found no difference in the effectiveness of acamprosate compared to placebo at reducing tinnitus loudness or severity. We also found that several participants experienced side effects so we do not recommend that individuals try it unless they are in very close contact with the prescribing physician during the trial.

The OHSU Tinnitus Clinic was closed by the ENT department in 2013. Two of us (my wife, Dr. Jennifer Martin) and I moved to start a tinnitus clinical program at the National University of Singapore. I don't know if you have accessed tinnitus management care in France but it should be available there. If not, you are always welcome to come to Singapore.

Best of luck with this,

Billy Martin

William Hal Martin, Ph.D.
Professor of Otolaryngology
National University of Singapore