Antioxidants, minerals, vitamins, and herbal remedies in tinnitus therapy.

The use of complementary and alternative medicine (CAM) is very popular in western countries and several CAM products are often used by individuals with tinnitus with or without medical guidance. CAM pharmacological approach to tinnitus today is mainly based on vitamins and minerals (dietary supplements), antioxidants, and herbal medications. Despite the popularity of CAM products, the evidence regarding their efficacy against tinnitus is in general scarce and their potential toxic effects are often underestimated or even neglected. In this paper the available literature on the efficacy of dietary supplements, antioxidants, and herbal medications against tinnitus is reviewed, and some of the major potential toxic effects are discussed. It is concluded that the use of CAM products in tinnitus therapy in general lack substantial scientific support, and that these substances are probably not clinically effective either. However, it is difficult to draw clear-cut conclusions regarding CAM pharmacological approach to tinnitus. In fact, the subjective nature of tinnitus and the reported variability in patient's response to therapy indicate that several non-pharmacological factors may be influencing drug effects, with the placebo effect playing a major role. Nevertheless, in view of the potential harm that may occur from inappropriate use of CAM products, physicians need to be aware of their principal characteristics with particular emphasis on toxicity and possibilities of interaction with prescription drugs.