New evidence shows ketamine infusion therapy may provide relief to people with tinnitus. However, more research is necessary to confirm its effectiveness and safety over time.

Tinnitus is a condition that causes persistent noise in the ears, which can cause discomfort and irritability. People with tinnitus may hear noise in one or both ears, even though there is no external sound. This is a common condition affecting many worldwide, especially older adults and those with hearing loss due to ear injuries.

Tinnitus can be difficult to manage. However, ketamine infusion therapy may offer relief to some those who have tried other tinnitus treatments with limited success.

This article will review the effect of ketamine on tinnitus, what tinnitus is, how ketamine works, and the other treatment options available for the condition.

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Researchers are investigating ketamine as a possible treatment for tinnitus, although its use remains experimental. While there is little research on its effectiveness, some evidence indicates that it may reduce symptoms in some instances.

Doctors think tinnitus results from atypical neural activity in the brain, and ketamine, a dissociative anesthetic, has specific properties that influence neurotransmitter systems, especially glutamate. Since glutamate plays a key role in brain activity, ketamine’s ability to block its receptors, called NMDA receptors, may help regulate the atypical brain activity linked to tinnitus.

A few small studies and case reports suggest ketamine infusion therapy could improve some people’s tinnitus perception. However, there are no current Food and Drug Administration (FDA)-approved ketamine treatments for tinnitus. Therefore, more comprehensive clinical trials are necessary to verify its safety and effectiveness.

What is tinnitus?

Tinnitus is the perception of sound, such as ringing, buzzing, or roaring, without any external source. It affects around 10% to 25% of adults and can also occur in children. While tinnitus sometimes improves or disappears, it can worsen over time and become chronic, lasting for 3 months or more.

The exact cause is unclear, but it has links to hearing loss. Tinnitus rarely relates to serious health problems and usually does not interfere with daily life. However, in severe cases, it can affect concentration, sleep, and mood and may lead to anxiety or depression over time.

Although no cure exists, people can manage tinnitus symptoms through sound therapy, behavioral treatments, and medications.

Learn more about tinnitus.

Ketamine affects several receptors and pathways in the brain and body, with one key pathway involving glutamate. As an NMDA receptor antagonist, ketamine blocks glutamate from binding to NMDA receptors.

Ketamine also influences pathways and opioid receptors in the brain, though it is unclear how these pathways interact or which is most important. The mTOR pathway helps ketamine promote the growth of new neural connections. However, researchers are unsure how they work on how the brain’s ability to reorganize itself following injury.

The combination of these effects seems to help improve tinnitus symptoms. However, more research is necessary as doctors do not fully understand how this affects tinnitus.

Tinnitus often results from underlying medical conditions, such as earwax buildup or jaw joint issues. Treating its underlying cause can significantly improve or even eliminate the symptoms. However, in some cases, tinnitus can be a persistent problem, lasting months or even years.

The treatments available for tinnitus may include:

  • Sound therapies: These stem from the idea that tinnitus occurs due to change in the brain’s neural circuits from hearing loss. Research indicates that sound exposure may help reverse some of these changes and ease symptoms. Additionally, sound therapy can mask tinnitus sounds, assist people in getting used to them, or serve as a distraction. There are various devices in sound therapy, including:
    • hearing aids
    • smartphone or tabletop sound generators
    • wearable sound generators
    • combination generators, such as hearing aids with built-in sound generators
  • Behavioral therapy and counseling: This consists of cognitive behavioral therapy (CBT), tinnitus retraining therapy, and education about tinnitus:
    • CBT: This helps individuals recognize negative thoughts that lead to distress. The therapist will guide people in altering their reactions to these negative thoughts. They will also encourage them to concentrate on positive changes that can lessen the effects of tinnitus on their lives. Research has demonstrated that this therapy can enhance the well-being of individuals experiencing tinnitus.
    • Tinnitus retraining therapy: This combines counseling and sound therapy to train the brain to become less aware of tinnitus. The counseling part focuses on helping people ignore the tinnitus sound and see it as neutral, while a low level, steady sound from an ear device aids in getting them used to the condition.
    • Education: Understanding tinnitus and its triggers can help ease anxiety by clarifying that, in most cases, it does not stem from a serious medical issue. Counseling can also teach people coping strategies and techniques to prevent symptoms from worsening.
  • Medications: There are no medications for treating tinnitus. However, doctors may prescribe antidepressants as an off-label treatment to improve mood or help improve sleep quality.

Tinnitus is a common condition involving persistent ringing in the ears, affecting 10% to 25% of adults. It often arises from hearing loss but has rare associations with serious health issues. While there is no cure, people can manage their symptoms through sound therapies, behavioral treatments, and medications.

Recently, researchers have also been exploring ketamine as a potential treatment for tinnitus. As an NMDA receptor antagonist, ketamine may help regulate atypical brain activity associated with tinnitus. Although some studies suggest it could improve symptoms, more comprehensive clinical trials are necessary to verify its safety and effectiveness.