The FDA has approved ketamine for two uses: for anesthesia and for depression that does not respond to regular antidepressants.
Ketamine has not been approved for the treatment of tinnitus.
What Is Ketamine?
A dissociative anesthetic successfully used for more than 50 years, ketamine in low doses can also treat mental illness — specifically, depression.
It's long been known to help prevent suicidal tendencies, especially because it acts so fast. In a 2015 article at Futurity, Christina Sumners wrote: "Ketamine acts quickly. Instead of the two or more weeks of a standard antidepressant, such as Prozac, Zoloft, or Effexor, ketamine acts within minutes to hours — which is vitally important in preventing suicide."
Does It Work?
However, ketamine efficacy in treating tinnitus is not proven, and anecdotal reports are actually pretty discouraging. Some people report that their tinnitus gets louder (going back to baseline when the drug fades), or has no effect at all on their tinnitus. Others say ketamine treatment helped in the moment, but not for the long term.
Deborah Copaken was in a clinical trial to see if ketamine would stop her tinnitus. She experience near-complete silence for two weeks, after which her tinnitus gradually grew louder again.
Theories Abound
There are lots of theories around why the club drug (ketamine is a dissociative anesthetic hallucinogen) might decrease tinnitus symptoms.
One is that ketamine makes people feel detached — not just from pain, but also their environment. If that's the case, then the drug may not reduce the tinnitus noise, but it makes people care less about it and so they don't focus on it as much.
Another theory is that ketamine enhances neuroplasticity, the brain cell’s ability to form new connections. If tinnitus is caused by neuroplasticity deprivation, this would make sense. By repairing neurons atrophied from chronic depression, or from hearing loss due injury to the auditory nerve, ketamine could indeed reduce tinnitus noise.
Clinical Trial
There's a very small clinical trial with 40 participants taking place at the moment, investigating ketamine as a treatment for tinnitus. Half of the patients involved experience symptoms of anxiety or depression with their tinnitus. Even though the study started in September 2019, results are not expected until December 2024.
However, the reason for testing ketamine as a possible tinnitus treatment becomes clear from this statement by the study's author, Dr. Diana Martinez:
"For many, tinnitus has an important affective component to it, with distress and co-morbid symptoms of depression and anxiety. The onset and severity of tinnitus can correlate with stressful events, and it has been posited that stress lowers the threshold of perception, and unmasks tinnitus. Tinnitus then triggers more anxiety and depressed mood, which in turn reinforces the symptoms. An advantage of ketamine may be its effect on depression and anxiety, in addition to tinnitus, to interrupt this cycle."
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