Comparative analysis of efficacy, safety, and cost-effectiveness of betahistine alone, caroverine alone, and caroverine plus ginkgo biloba in moderate tinnitus.

Background: Tinnitus or "phantom sound" continues to be a significant health problem without a uniformly accepted treatment. Numerous pharmaceutical options have been investigated, but satisfactory results are yet to be obtained.

Objectives: The objectives of this study were to study and compare the efficacy, safety, and cost-effectiveness of caroverine alone, caroverine combined with ginkgo biloba and betahistine alone in patients of moderate tinnitus.

Materials and methods: In this prospective, observational, hospital-based study, wherein 72 patients were distributed equally across three groups - Group A received caroverine 20 mg twice daily, Group B received caroverine 20 mg combined with ginkgo biloba 120 mg twice daily, and Group C received betahistine 8 mg thrice daily for 12 weeks. Efficacy was zanalyzed assessing the changes in tinnitus handicap inventory (THI), tinnitus functional index (TFI), Visual Analog Scale (VAS) score, and pure tone audiometry values from baseline at 4, 8 and 12 weeks. The cost-effectiveness analysis was done at the end of 12 weeks zutilizing the incremental costeffectiveness ratio. The Chi-square test and one-way ANOVA were used to evaluate the statistical significance of the results.

Results: The reduction in the THI, TFI and VAS scores was maximum in Group B followed by Group A and Group C. All the drugs were well-tolerated, and the adverse effects encountered were mild and nonserious. Combination therapy of caroverine with gingkgo biloba was the most expensive.

Conclusion: Caroverine and ginkgo biloba combination therapy was the most effective in reducing the handicap of moderate tinnitus.