O uso do clonazepam no tratamento do zumbido em indivíduos em processo de envelhecimento: uma revisão sistemática

Abstract

Tinnitus is a prevalent symptom in the general population, particularly in the elderly, and its treatment is still a challenge in daily clinical practice. Clonazepam is a medication used routinely as a treatment. However, few studies have reported the actual efficacy of this drug for tinnitus relief. Objective: To verify the effect of the use of clonazepam in the treatment of tinnitus in individuals in the process of aging. Method: A systematic review was performed with a meta-analysis according to PRISMA standards and registered in PROSPERO under the number CRD42018087346. The surveys were carried out in the Medline (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), SciELO and Lilacs (Bireme) databases ofarticles published until February 2018, with no language restriction. The inclusion criteria were randomized controlled trials (RCTs) in adults older than 18 years with tinnitus, in which the intervention would be the use of clonazepam in the presence of a control group (medication or placebo) using some evaluation instrumentation for the evaluation of tinnitus. The research was performed independently by two researchers. Results: Among the 133 identified papers, only two met the inclusion criteria and, therefore, were analyzed. The result of the visual analogue scale was the only coincident instrument of the analyzed studies, and was used to compared by means of meta-analysis. A total of n = 96 participants was recorded. The mean of the visual analogue scale was 2.41 with 95% CI (3.62, 1.20). The test for the overall effect obtained was significant (p <0.0001). The heterogeneity was I2= 49%. Through the meta-analysis it was found that clonazepam had a positive effect with statistically significant results in the treatment of tinnitus. However, some counterpoints of the studies are emphasized, such as a small sample, not very homogeneous, short intervention time and uncertain parameters regarding bias risk assessment, which places less credibility on the quality of the results. Conclusion: This systematic review with meta-analysis suggests that clonazepam is an option in the treatment of tinnitus. However, the methodological quality of the articles included, the small sample size and the short intervention period suggest that new RCTs on this subject are needed.