Sorry for the length of the post. I have spent a lot of time worrying about ototoxicity without paying attention to the fine print, and I now find it is helpful to try to quantify the risk. As I said above, I think sleep is important. But if sleep came with a high probability of permanently increasing tinnitus, that is not a good thing... So I looked into ambien a bit. For the record, I have taken it prior to having tinnitus with no problems. The bigger side effects I am aware of are that you can appear to be completely awake - have conversations (I did this), get up and do things, etc without any memory of the events.
But isn't ambien also ototoxic?
It depends on what you mean by "ototoxic". If you mean is it known to cause permanent hearing loss, then no I don't think it is.
Tinnitus is listed as a side effect - as it is on almost every drug that I have seen - and I do the same kind of research you are doing. It turns out that there is more information on Ambien than there is on some other drugs I have researched. The following information is taken from
http://www.rxlist.com/ambien-side-effects-drug-center.htm
"
Special senses: Frequent:
diplopia, vision abnormal. Infrequent: eye irritation, eye pain,
scleritis, taste perversion,
tinnitus."
So it is listed as an "infrequent" side effect but it isn't immediately clear what "infrequent" means. It turns out that "infrequent adverse events are those occurring in 1/100 to 1/1,000 patients".
Where do they get these frequencies from? (emphasis added)
"
AMBIEN was administered to 3,660 subjects in clinical trials throughout the U.S., Canada, and Europe. Treatment-emergent adverse events associated with clinical trial participation were recorded by clinical investigators using terminology of their own choosing. To provide a meaningful estimate of the proportion of individuals experiencing treatment-emergent adverse events, similar types of untoward events were grouped into a smaller number of standardized event categories and classified utilizing a modified World Health Organization (WHO) dictionary of preferred terms.
The frequencies presented, therefore, represent the proportions of the 3,660 individuals exposed to zolpidem, at all doses, who experienced an event of the type cited on at least one occasion while receiving zolpidem. All reported treatment-emergent adverse events are included, except those already listed in the table above of adverse events in placebo-controlled studies, those coding terms that are so general as to be uninformative, and those events where a drug cause was remote.
It is important to emphasize that, although the events reported did occur during treatment with AMBIEN, they were not necessarily caused by it."
So these are things that were reported to have occurred at least one time for one person. In an analysis like this, there is no way to show causality. After all, arthritis is also listed as an "infrequent" side effect!
What is more interesting is the comparison of "adverse events" between the treatment group and control group. They have some information on that. Tinnitus isn't mentioned, but dizziness is.
Just to conclude, some of the frequent side effects are
ataxia, confusion,
euphoria, headache, insomnia, vertigo,
dyspepsia, hiccup, nausea, upper respiratory infection, lower respiratory infection,
urinary tract infection.
I could do without most of these, but euphoria doesn't seem too bad. Ironic that insomnia is listed as a 'frequent' side effect.