Tandon R, Grunhaus L, Greden J F
J Clin Psychiatry. 1987 Mar;48(3):109-11.
Although tinnitus is listed among the rare neurologic side effects of tricyclic antidepressants, little is known about its prevalence, mechanism of development, course, and management. A chart review of 475 patients treated with tricyclic antidepressants indicated that tinnitus occurred in about 1% of the patients. The case vignettes of 5 patients who developed tinnitus in the course of imipramine therapy are presented. Each developed tinnitus in the second or third week of treatment with imipramine at daily dosages of 150-250 mg and at combined plasma imipramine-desipramine levels between 200-450 ng/ml. In each patient, tinnitus subsided spontaneously within 2-4 weeks of onset without any specific treatment, even though the daily dosage of imipramine and the plasma tricyclic levels were constant or increased. Possible mechanisms of development of tinnitus and implications for tricyclic antidepressant therapy are discussed.
尽管耳鸣被列为三环类抗抑郁药罕见的神经副作用之一，但对其患病率、发病机制、病程及治疗方法却知之甚少。一项对475例接受三环类抗抑郁药治疗患者的病历回顾表明，约1%的患者出现耳鸣。本文介绍了5例在丙咪嗪治疗过程中出现耳鸣的病例。每位患者在使用丙咪嗪治疗的第二或第三周出现耳鸣，日剂量为150 - 250毫克，血浆丙咪嗪 - 去甲丙咪嗪联合水平在200 - 450纳克/毫升之间。在每位患者中，耳鸣在发病后2 - 4周内自行消退，无需任何特殊治疗，尽管丙咪嗪的日剂量和血浆三环类药物水平保持不变或有所升高。本文讨论了耳鸣可能的发病机制以及对三环类抗抑郁药治疗的影响。
