Bagcilar Education And Research Hospital, Department of Psychiatry, 34400 Istanbul, Turkey.
Gen Hosp Psychiatry. 2012 May-Jun;34(3):282-9. doi: 10.1016/j.genhosppsych.2011.12.006. Epub 2012 Jan 27.
The aim of this review to investigate presence of psychopathological states and efficacy of psychopharmacological drugs in the treatment of tinnitus.
An extensive Internet search has been performed for this aim through PubMed by using related key words in English.
Higher anxiety and depression levels and somatoform disorder clusters are defined in patients with tinnitus. Additionally, impulsivity, hostility, demanding, physical discomfort, anxiety for health, emotionality and suicidal tendency are also defined in these people. Personality characteristics in these patients are depression, hysteria and hypochondriac features. Besides these symptom clusters, more severe psychopathologies like personality disorders may be encountered in these patients. Sertraline, paroxetine and nortriptyline can be considered as the first-line antidepressants in the psychopharmacological treatment of tinnitus. There are studies which have reported the efficacy of sulpiride. Carbamazepine, valproate and gabapentin can be effective as mood stabilizers. Short-acting benzodiazepines like alprazolam and midazolam are effective in signs of anxiety. Clonazepam and diazepam can be evaluated as other options. However, some glutamate receptor antagonists also can be used in the treatment of tinnitus. Disturbed sleep is frequently associated with tinnitus. Sleep disturbance can disrupt the quality of life in the patients with tinnitus. These patients might benefit from cognitive-behavioral therapy, which offers the promise of relief from tinnitus-related distress and insomnia.
When pathophysiologic reasons are excluded, it should be at least considered that tinnitus is exaggerated by psychopathological symptoms. Life quality of patients can be increased by treating these symptoms.
本综述旨在研究耳鸣患者的精神病理状态及精神药理学药物治疗的疗效。
为此目的，通过在 PubMed 中使用相关的英文关键词，进行了广泛的互联网搜索。
耳鸣患者的焦虑和抑郁水平较高，躯体形式障碍群也较明显。此外，这些人还表现出冲动、敌意、苛求、身体不适、对健康的焦虑、情绪和自杀倾向。这些患者的人格特征为抑郁、癔症和疑病症。除了这些症状群，这些患者可能还会遇到更严重的精神病理障碍，如人格障碍。在耳鸣的精神药理学治疗中，舍曲林、帕罗西汀和去甲替林可被视为一线抗抑郁药。有研究报道了舒必利的疗效。卡马西平、丙戊酸钠和加巴喷丁可作为情绪稳定剂有效。阿普唑仑和咪达唑仑等短效苯二氮䓬类药物对焦虑症状有效。氯硝西泮和地西泮也可以作为其他选择。然而，一些谷氨酸受体拮抗剂也可用于治疗耳鸣。睡眠障碍常与耳鸣相关。睡眠障碍会扰乱耳鸣患者的生活质量。这些患者可能受益于认知行为疗法，该疗法有望减轻耳鸣相关的痛苦和失眠。
当排除生理病理原因时，至少应该考虑耳鸣是由精神病理症状引起的。治疗这些症状可以提高患者的生活质量。
