Tinnitus and it's treatment with Caroverin

The following publication is given for general information purpose only and not as a treatment or cure recommandation.

The symptom tinnitus may be due to various causes. Therefore, an exact audiological examination is absolutely necessary. The tinnitus therapy with transmitter antagonists can influence a special form of tinnitus - the so called cochlear synaptic tinnitus. It is caused by functional disturbances in the synapse between the inner hair cells and the afferent dendrites of the auditory nerve. This may be the case in sudden hearing loss, hearing loss in the elderly ("presbycusis") or noise-induced hearing loss. The cochlear synapse has the following characteristics:

Glutamate is supposed to be the transmitter substance.

Two different receptor types work as a dual receptor system: NMDA (N-methyl-D-aspartate) and non-NMDA-receptors (Quisqualate, Kainate) on the subsynaptic membrane.

This dual receptor system is responsible for a typical pattern of depolarization, which can be shown in microiontophoretic animal experiments. Under pathological conditions, spontaneous receptor-dependent depolarization patterns mimic sound-induced patterns, which are perceived as tinnitus. By intravenous application of transmitter antagonists like Caroverin the synaptic function can be improved and the tinnitus reduced. All other forms of tinnitus cannot be reduced by transmitter antagonists.

The tinnitus treatment with Caroverin is indicated in cases of cochlear synaptic tinnitus. Therefore, a thorough ENT and audiological examination is necessary before therapy, to rule out other tinnitus causes. If necessary, the diagnostic measurements should also comprise brainstem audiometry.

Caroverin has benefitted up to 60 % of the patients treated for the cochlear tinnitus type (clinical studies).

Caroverin for cochlear tinnitus is not yet available as a registered drug. The tinnitus indication is presently under examination by the Health authorities.

For tinnitus treatment (cochlear synaptic tinnitus type), Caroverin is applied as slow intravenous infusion (2 ml per minute). The dosage of Caroverin differs from patient to patient and depends on the tinnitus reduction achieved in the individual patient. When the tinnitus is reduced, the infusion is stopped. At maximum, 160 mg Caroverin are given in 100 ml physiologic saline solution. Until now, one has not observed any severe side-effects. In some patients, a slight transient headache or dizziness occured.

Ear drops are under development.

The pharmaceutical tinnitus formulation of Calmavérine® is still under development. But meanwhile and in collaboration with Laboratoire Mergens, Switzerland, we have introduced on the market an ear spray named Calmaspray® which can help in many cases of tinnitus, click here.

Brand Name: Calmaverine® (active principle Caroverin), Switzerland.

Precautions/Warnings: Hyperthyroidism; cardiac insufficiency; muscular weakness in the elderly and disabled.

Contraindications: Glaucoma; prostate hypertrophy; duodenal obstruction.

Interactions: Phenothiazines; anticholinergics; antihistamines; tricyclic antidepressants ; digoxin.

Adverse Effects: Dry mouth; blurred vision; urinary retention; tachycardia.

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