Ethyl loflazepate as adjunctive therapy to tinnitus retraining therapy - A report of 30 cases

Introduction: Among patients with tinnitus, treatment success is often difficult to achieve with tinnitus retraining therapy (TRT) alone in patients in whom hearing aids cannot be used as acoustic therapy and those in whom tinnitus causes anxiety or sleep disorders. We investigated the clinical courses of patients in whom ethyl loflazepate was used as an adjunctive therapy to TRT. Subjects: This study was conducted in 30 patients who visited our hospital with the chief complaint of tinnitus from 2013 to 2016 and had intermediate or higher score on the tinnitus handicap inventory (THI) and anxiety or sleep disturbance due to tinnitus. Of the 30 patients, 17 had sensorineural hearing loss (including 6 with senile deafness), 4 had mixed hearing loss, 1 had Ménière's disease, and 8 had tinnitus without hearing loss. The score on the THI at the first visit was 52.5±18.9. Method: The patients were prescribed 1 mg of ethyl loflazepate, in addition to TRT. The patients were instructed to gradually reduce the intake of the drug with symptom improvement, and eventually discontinue the drug. TRT was continued in all cases. The progress was followed up to 2018. Results: We recommended the use of hearing aids as acoustic therapy as a component of TRT in 21 patients with hearing loss, but not in 8 cases of tinnitus without hearing loss and 1 case of Ménière's disease; finally, 8 patients continued to use hearing aids. The final score on the THI was 26.7±20.8, indicating a statistically significant decrease of the score as compared to that at the first visit (improvement rate, 63.3%). As of 2018, ethyl loflazepate could be discontinued in 25 patients. Conclusion: Ethyl loflazepate as an adjunctive therapy to TRT should be used with caution owing to its potential to cause dependence, but it is an available option in cases with intermediate or higher scores on the THI with anxiety or sleep disturbance due to tinnitus.