Tinnitus Treatments: What Does the Evidence Show?
Tinnitus treatments can affect different outcomes — tinnitus loudness (the sound itself), tinnitus distress and severity (THI/TFI questionnaires), sleep, anxiety and quality of life, underlying conditions, or hearing itself. Most treatments with good evidence improve distress rather than loudness, which is why every treatment here is rated on loudness and distress separately — we never blur the two.
Currently tracking 38 treatments across 12 categories, each with evidence scores, replication and independence status, safety, availability and full primary-source citations. Prefer filters and search? Open the interactive browser.
Tier 1 — strongest current evidence
- Cognitive Behavioral Therapy (CBT) — A structured talk therapy — the best-evidenced tinnitus treatment. It doesn't quiet the sound, but reliably reduces its impact on your life.
Tier 2 — promising
- Auricle bisensory stimulation (Susan Shore device) — The only treatment with rigorous randomized evidence of making tinnitus quieter — still stuck in the lab.
- Lenire (bimodal tongue stimulation) — Pairs sound with mild tongue stimulation — the first and only device of its type the FDA has authorized for tinnitus. Large trials and…
- Digital CBT & app-based therapeutics — CBT's evidence, delivered by app — the fastest-maturing corner of the field, with the first sham-controlled wins.
- Cochlear implants (for qualifying hearing loss) — For people with severe hearing loss, implantation often genuinely reduces the tinnitus sound itself — one of the few things that does. It…
- Hearing aids (with hearing loss) — If you have hearing loss with tinnitus, treating the hearing loss is one of the most effective single moves.
- CBT for Insomnia (CBT-I) — Tinnitus keeps you awake; insomnia makes tinnitus worse. Treating the insomnia breaks the loop.
- Acceptance & Commitment Therapy (ACT) — Stop fighting the sound — a well-supported CBT cousin built on acceptance rather than control.
- Mindfulness-Based Cognitive Therapy (MBCT) — The best-tested mindfulness approach for tinnitus — it outperformed a genuine comparison treatment (not just a waiting list), and the…
- Venous sinus stenting (pulsatile tinnitus) — Pulsatile tinnitus is a different disease — and when a venous narrowing is the cause, stenting resolves it in most patients.
Tier 3 — experimental/emerging
- SPI-1005 (ebselen) — The most advanced drug with a tinnitus-relevant claim — but its trials are in Meniere's disease, and the tinnitus data are unblinded.
- Physiotherapy & TMJ treatment (somatic tinnitus) — When tinnitus changes with your jaw or neck, treating the jaw or neck can change the tinnitus.
- rTMS (repetitive transcranial magnetic stimulation) — Statistically real but clinically small — and whether any benefit lasts to 6 months is disputed between the major analyses.
- tDCS / tACS / tRNS (transcranial electrical stimulation) — Cheap and safe, possibly a mild adjunct — the evidence is too heterogeneous to say more.
- Paired vagus nerve stimulation (VNS) — A promising pilot, then silence — the sponsor took the technology to stroke rehab instead.
- Notched sound / notched music therapy — Music with your tinnitus frequency carved out — a modest, unconfirmed loudness effect in tonal tinnitus.
- TrueSilence / digital polytherapeutic (Searchfield) — Thirty years of Auckland tinnitus research just became a startup — personalized, gamified sound therapy by phone.
- Sigmoid sinus wall reconstruction (pulsatile tinnitus) — Surgical repair of a defect in the bony wall of the sigmoid sinus — an alternative to stenting for one specific, imaging-confirmed cause…
- Transcutaneous auricular VNS (taVNS) — Non-surgical vagus nerve stimulation via an ear clip — small pilots so far, with the largest trial ever now running.
- Levo System (sleep-time sound matching) — FDA-cleared sound therapy played during sleep, matched to your tinnitus 'sound print' — one small positive trial.
- TRTL-913 (GABA-A modulator) — A new $106M bet that a GABA-A drug can quiet tinnitus — Phase 2 starts soon; no human tinnitus data yet.
- Neosensory Duo (wristband bimodal) — A consumer wristband borrowing the bimodal idea — sold on one small company-run study.
- Hair-cell regeneration & inner-ear gene therapy — Gene therapy is genuinely restoring hearing in deaf children — but nothing in the regenerative pipeline measures tinnitus yet.
- Transcranial focused ultrasound (emerging) — Focused ultrasound can reach deep brain circuits no coil can — first tinnitus study starting at Oxford; no human data yet.
Tier 4 — symptom management/coping
- Sound therapy & masking — Widely used, low-risk, valued by many — but never proven better than placebo in controlled trials.
- Tinnitus Retraining Therapy (TRT) — The counseling helps — but the trial designed to prove TRT found its sound generators added nothing.
- Combination aids & fractal tones (e.g., Widex Zen) — Hearing aids with built-in tinnitus sounds — sensible, but the tinnitus add-ons lack independent proof.
- Biofeedback & EEG neurofeedback — Clinics sell it at high cost; the best trial found the specific 'brain training' doesn't matter — the coping does.
Tier 5 — weak or unsupported
- Acupuncture — The world's most-used complementary tinnitus treatment — low-quality trials say yes, higher-quality analysis says unproven.
- Hyperbaric oxygen therapy (HBOT) — Oxygen chambers are sold for tinnitus at hundreds of dollars a session; Cochrane says routine use 'cannot be justified'.
- Low-level laser therapy / photobiomodulation — Home ear-lasers are sold online today; the meta-analysis verdict is null — and statistically unlikely to change.
- Neuromonics (and other discontinued cleared devices) — A once heavily marketed $5,000 'acoustic desensitization' program — FDA-cleared, weakly evidenced, now largely defunct.
- Acoustic coordinated reset (Desyncra) — A elegant theory whose confirmatory trial came back empty.
- Intratympanic drug injections — Injections through the eardrum keep failing their controlled tests — the placebo response is doing the work.
- Off-label oral drugs (antidepressants, benzodiazepines, gabapentin, betahistine) — No drug is approved for tinnitus anywhere — and the systematic reviews say none of the usual suspects works on the tinnitus itself.
- Supplements (ginkgo, zinc, melatonin…) — Heavily marketed, repeatedly tested, consistently unsupported.
- Cannabis / CBD — 'CBD for tinnitus' is aggressively marketed. There are zero human trials — and population data point the wrong way.
- Hypnotherapy — Widely offered privately, often with confident claims — there is no evidence it works for tinnitus.