Gabapentin, sold under brand names including Neurontin, is an anticonvulsant that was tested as a treatment for chronic subjective tinnitus from the mid-2000s. Placebo-controlled trials found it no more effective than a dummy pill, and systematic reviews concluded that the evidence is insufficient to support using it for tinnitus.

Why it matters for tinnitus

The case for trying it was indirect. Nerve injury is one suspected cause of tinnitus, and gabapentin had been found useful in nerve injury, so researchers asked whether it might quiet the sound too. Early work suggested it might help people whose tinnitus followed noise damage. The placebo-controlled trials that followed did not bear that out.

What the evidence says

A PubMed search for gabapentin and tinnitus returns 37 records, but the controlled trials among them are few and small.

  • Randomised trials. A double-blind trial at a US academic clinic enrolled 135 adults with severe tinnitus lasting six months or more and compared gabapentin (900 to 3,600 mg a day) with placebo for eight weeks. Scores on the Tinnitus Handicap Inventory fell by 11.3 points in the 59 on gabapentin and 11.0 in the 56 on placebo (P = .91), and the authors concluded it was no more effective than placebo. A second trial, in which 76 patients completed treatment and 52 received the drug at 1,800 mg a day, found no significant difference after five weeks. A third, with 40 patients on gabapentin and 40 on placebo, found no significant difference in severity or loudness; a better response in people who also had high blood pressure, diabetes or raised blood fats was a subgroup finding.
  • A smaller single-blind study. A study in which all 39 participants took gabapentin on a rising and then falling dose schedule reported less annoyance in people whose tinnitus followed acoustic trauma (P = .05), with other measures unchanged and wide variation between individuals.
  • Systematic reviews. A Cochrane review of anticonvulsants included seven trials with 453 patients. Most were at high or unclear risk of bias. One trial found gabapentin made Tinnitus Questionnaire scores 18.4 points worse than placebo, and pooling two gabapentin trials showed no effect (SMD 0.07, 95% CI −0.26 to 0.40). Side effects affected 18% of patients across the anticonvulsants studied. Two further reviews, of two and of four double-blind trials, both concluded that the evidence is insufficient to support gabapentin.
  • A dissenting analysis. A 2021 network meta-analysis of 36 randomised trials with 2,761 participants listed gabapentin among drugs associated with more improvement in severity than placebo. It found no drug that changed quality of life.
  • Guideline. The AAO-HNS clinical practice guideline recommends against anticonvulsants for the routine treatment of persistent, bothersome tinnitus.
  • Case report. A 2022 report describes a woman with typewriter tinnitus, a rare syndrome thought to come from a blood vessel pressing on the hearing nerve, who responded well to gabapentin. A single case is not evidence for ordinary tinnitus.

What this means for you

Gabapentin is not a recognised tinnitus treatment, and the AAO-HNS guideline advises against anticonvulsants for routine tinnitus care. It is not among the treatments rated on the treatment comparison page. If you already take gabapentin for another condition, talk to the prescriber before changing it. Tinnitus that arrives with a sudden drop in hearing over hours to three days needs same-day care, as explained in sudden sensorineural hearing loss.

How it connects