Tinnitus Risk Increase With Regular Use of Painkillers

The frequent use of painkillers available without prescription can potentially cause tinnitus, according to a new longitudinal study led by investigators at Brigham and Women’s Hospital. The study findings are published in the Journal of General Internal Medicine.

Millions of Americans experience tinnitus, often to a disabling degree. Tinnitus is the perception of sound when no actual external noise is present.

Commonly described as “ringing in the ears,” tinnitus can also be experienced as many different perceptions of sound, such as buzzing, hissing, whistling, swooshing, and clicking. Tinnitus can be transient or temporary, or it can be a persistent, long-term condition.

Aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), and acetaminophen are some of the most commonly used medications that are widely available without a prescription and perceived to be safe.

Very high doses of over-the-counter painkillers can lead to reversible tinnitus, but researchers investigated whether frequent use of typical doses of common painkillers is associated with the risk of developing chronic persistent tinnitus.

“Our findings suggest that analgesic users may be at higher risk for developing tinnitus and may provide insight into the precipitants of this challenging disorder,” said lead author Sharon Curhan, MD, ScM, of the Brigham’s Channing Division of Network Medicine.

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Researchers conducted the study among 69,455 women who were participants in a large, ongoing longitudinal investigation that examines risk factors for hearing loss and tinnitus among participants in several large, ongoing prospective cohort studies.

Women were between the ages of 31 and 48 at the time of enrollment and were followed for over 20 years. The primary outcome examined was an incident (new-onset) persistent tinnitus, defined as tinnitus that was experienced by the participant several days per week or more.

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They also examined alternative definitions of tinnitus, including persistent tinnitus lasting 5 minutes or longer and tinnitus experienced every day.

Participants answered questions (before the development of tinnitus) about their use of over-the-counter pain medications as well as the use of COX-2 inhibitors, a prescription NSAID with similar properties to other NSAIDs but with fewer gastrointestinal side effects.

The study results show that frequent use (6 to 7 days per week) of moderate-dose aspirin was associated with a 16 percent higher risk of tinnitus among women aged less than 60 but not among older women.

Frequent use of NSAIDs or frequent use of acetaminophen was associated with an almost 20 percent higher risk of developing tinnitus, and the magnitudes of the elevated risks tended to be greater with more frequent use.

Regular use (2 or more days per week) of COX-2 inhibitors was associated with a 20 percent higher risk of developing tinnitus as well.

The authors note that information on tinnitus and analgesic use was self-reported by participants. Due to the nature of the condition, subjective tinnitus is perceived only by the individual, so the researchers needed to rely on self-reporting.

Source-Medindia