Tinnitus sound or noise levels can lead to tinnitus. Ear plugs or other measures can help with prevention. Several medicines have ototoxic effects, and can have a cumulative effect that can increase the damage done by noise. If ototoxic medications must be administered, close attention by the physician to prescription details, such as dose and dosage interval, can reduce the damage done. If there is an underlying cause, treating it may lead to improvements. Otherwise, the primary treatment for tinnitus is talk therapy and sound therapy; there are no effective medications. The best supported treatment for tinnitus is a type of
Tinnitus retraining therapy called it masking), an integral part of TRT, found no convincing evidence of the efficacy of sound therapy in the treatment of tinnitus. A summary in The Lancet concluded that in the only decent study, TRT was more effective than masking; in another study in which TRT was used as a control methodology, TRT showed a small benefit. A study which compared cognitive behavior therapy (CBT) in combination with the counselling part of TRT versus standard care (ENT, audiologist, maskers, hearing aid) found that the specialized care had a positive effect on quality of life as well as specific tinnitus