Effectiveness of Over‐The‐Counter Treatments for Tinnitus Symptom Relief: A Systematic Review

ABSTRACT

Objective

To review the effectiveness of over‐the‐counter (OTC) treatments in reducing tinnitus symptom severity as measured by the Tinnitus Handicap Inventory (THI) in randomized controlled trials.

Methods

A comprehensive search was conducted in PubMed, Embase, Cochrane CENTRAL, ClinicalTrials.gov, and WHO ICTRP through March 2025. A systematic review of nine randomized controlled trials (RCTs) including 390 adults was conducted. Eligible studies evaluated oral OTC treatments with pre‐ and posttreatment THI scores. Because of substantial clinical and methodological heterogeneity and incomplete reporting of variance data required for pooled effect estimation, we performed a qualitative systematic review rather than a meta‐analysis.

Results

Nine RCTs comprising 390 participants met inclusion criteria. Investigated agents included melatonin, Ginkgo biloba, α‐lipoic acid, açaí extract, and several combination antioxidant or herbal formulations. Several trials reported within‐group reductions in THI scores for active treatments; however, findings were inconsistent across agents, placebo responses were common, and most products were evaluated in only a single small study. Variation in dosage, treatment duration, and study design limited direct comparison between trials.

Conclusion

Current RCT evidence shows inconsistent and limited findings, and no firm conclusions can be drawn about whether any OTC therapy provides symptomatic benefit. Future trials should use standardized outcome measures, transparent reporting, and adequately powered designs to clarify which, if any, OTC treatments provide clinically meaningful benefit.

Level of Evidence

1 (Systematic review of RCTs with low‐moderate heterogeneity).

Trial Registration: CRD42024549791.

This systematic review of randomized trials evaluated over‐the‐counter agents, primarily melatonin, Ginkgo biloba , zinc, and antioxidant combinations, for subjective tinnitus, using the Tinnitus Handicap Index (THI) as the primary outcome. At present, no OTC therapy can be recommended as an evidence‐based treatment for tinnitus, either alone or as an adjunct. Rigorous, adequately powered RCTs with standardized THI and complementary outcome measures are needed to clarify efficacy and guide clinical recommendations.

1. Introduction

Tinnitus is the perception of ringing or other sound in the absence of any external auditory stimulus. Tinnitus is generally subjective, as the examiner cannot hear the sound, and at this time there are no tools that can measure or directly perceive subjective tinnitus [1, 2]. We focus specifically on subjective tinnitus in this review. Addressing subjective tinnitus is challenging as it presents secondary to complex pathophysiology, lacks objective biomarkers, is often associated with comorbid psychological issues, and there are a lack of effective treatment options [3, 4, 5]. Current first‐line therapies include hearing aid use with or without a masking feature, cognitive behavioral therapy (CBT), sound therapy, and in select cases, pharmacologic management targeting comorbid depression or anxiety, such as tricyclic antidepressants (TCAs) and benzodiazepines [3]. There remains no FDA‐approved pharmacological treatment specifically for subjective tinnitus. In response to this treatment gap, many patients seek over‐the‐counter (OTC) options such as melatonin, Ginkgo biloba , magnesium, zinc, herbals, and antioxidant formulations. Although individual trials report varying degrees of benefit, overall the evidence remains inconsistent and heterogeneous.

Since there is a lack of an objective measure of subjective tinnitus, this has led to the creation of self‐reported questionnaires as the best option for evaluation of tinnitus symptoms and their impact on one's quality of life [6]. In 2022, one study evaluated the THI and the Tinnitus Functional Index (TFI), two of the most widely used questionnaires for evaluating tinnitus. Researchers found that both questionnaires were good at evaluating baseline and treatment‐related changes, but the TFI demonstrated a slightly better ability in detecting smaller changes in tinnitus severity [7]. As one recent scoping review notes, there is a high degree of heterogeneity used in studies evaluating tinnitus and treatment responses, with some using the THI, TFI, or Visual Analog Scale (VAS) in various combinations or one of those tests as a stand‐alone metric [8]. While the THI may not be the ideal metric for quantifying short‐term treatment responses, it remains the most widely used clinical tool to quantify symptom burden. Developed in 1996, the THI is comprised of 25 items and measures emotional, functional, and catastrophic domains, offering robust psychometric reliability across populations [9].

This systematic review evaluates whether OTC therapies are associated with changes in tinnitus‐related handicap as measured by the THI. Because the THI reflects perceived functional and emotional burden rather than tinnitus presence or loudness, any improvements should be interpreted as changes in handicap rather than direct evidence of physiological tinnitus reduction. To our knowledge, this is one of the first systematic reviews focusing exclusively on OTC oral agents with standardized THI outcomes from randomized controlled trials. Our goal is to provide clinicians and researchers with a structured overview of the available RCT evidence, highlight gaps in the literature, and outline priorities for future trial design.

1.1. Research Question

This systematic review was guided by the following question: Among adults with subjective tinnitus, what is the nature and consistency of evidence from randomized controlled trials that oral OTC therapies reduce symptom severity as measured by the THI compared with placebo or routine therapy?

2. Methods

Analyses were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. The protocol was reviewed by the Cooper University Health Care and deemed exempt from Institutional Review Board (IRB) oversight, as the study exclusively utilized de‐identified data extracted from previously published trials. The protocol is available upon request.

A comprehensive search strategy was employed to identify eligible studies across five electronic databases: PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP). Searches covered all records available through March 2025 and included search terms such as “tinnitus,” “over‐the‐counter,” “melatonin,” “ Ginkgo biloba ,” “zinc,” and “Tinnitus Handicap Inventory” (Table S1). A complete list of search terms can be found in the Appendix. The initial search yielded 1448 records—768 from Embase, 318 from PubMed, 305 from CENTRAL, 34 from WHO ICTRP, and 23 from ClinicalTrials.gov. Following the removal of 380 duplicates, 1068 records remained for title and abstract screening. Of these, 126 were selected for full‐text review based on title and abstract relevance to RCTs assessing tinnitus interventions using validated outcome measures. These studies were then screened, and many were excluded for several reasons such as the lack of a control group (n = 16), use of a prescribed or surgical therapy (n = 4), a lack of randomization and blinding (n = 19), or the use of an outcome measure other than the THI (n = 40) (see Figure 1 for detailed screening process). Ultimately, nine RCTs met the inclusion and exclusion criteria and were included in the final analysis (Figure 1).

FIGURE 1.

PRISMA flow chart demonstrating the screening process from the initial search to inclusion of RCTs.

2.1. Eligibility Criteria (PICOS Framework)

Studies were included based on the following PICOS criteria (see Table S2) for specific criteria:

Population (P): Adults (≥ 18 years) diagnosed with subjective tinnitus using a questionnaire or clinical diagnostic criteria.

Intervention (I): Orally administered OTC medications, herbal or homeopathic remedies, or dietary supplements (single or combination agents), with no restriction on dosage or formulation.

Comparator (C): Placebo control or routine therapy.

Outcome (O): Tinnitus severity assessed using validated THI scores, with extractable pre‐ and posttreatment means and standard deviations.

Study Design (S): RCTs, including parallel‐group and crossover designs.

Studies were excluded if they involved prescription‐only medications, lacked THI outcome data, were observational or uncontrolled in design, or included interventions as part of complex multimodal treatments where the OTC effect could not be isolated.

Studies were considered eligible if they enrolled adult participants with tinnitus and evaluated OTC treatments. Eligible studies were also required to report outcomes using pre‐ and posttreatment THI scores and to provide extractable means and standard deviations. Because of the widespread use of the THI to date, and as research methodologies adapt to the new data regarding the effectiveness of available outcome measures, the THI was chosen as the primary outcome measure in our analysis to improve homogeneity of results. In addition to outcome data, we extracted study‐level characteristics such as treatment type, dosage, duration, and population demographics. When data were missing or unclear, we contacted authors when feasible. Studies were excluded if they involved prescription‐only medications, lacked quantitative THI outcome data, used observational or case series designs, or lacked a proper control group.

Four independent reviewers (RM, JZ, AT, OB) extracted data related to sample size, type and duration of intervention, dosage, and pre/posttreatment THI scores. Discrepancies were addressed through consensus during review meetings. Risk of bias was evaluated using a modified Cochrane Risk of Bias Tool (Table S3) with rationale (Table S4), which assessed key domains such as randomization processes, deviation from intended interventions, missing data, outcome measurement, and selection of reported results [10]. All extracted data and analysis files are available from the corresponding author upon request.

Because of substantial clinical and methodological heterogeneity across studies, including differences in intervention type, dosage, treatment duration, and reporting of variance measures, and because necessary data for calculating between‐group effect sizes were unavailable for several trials, we did not perform a quantitative meta‐analysis. Instead, we synthesized findings qualitatively, organizing results by intervention class and summarizing THI changes and key trial characteristics descriptively.

3. Results

Ten treatment arms from nine RCTs were included, encompassing a total of 390 participants. The sample sizes ranged from as few as 12 to as many as 104 individuals per study. Interventions varied in type, including melatonin, Ginkgo biloba , and combination antioxidant or herbal formulations. The treatment durations in these trials ranged from 4 weeks to 6 months, and all studies utilized the THI to evaluate symptom severity before and after the intervention (Table 1).

TABLE 1.

RCTs included in systematic review.

Study (author, year)	Treatment evaluated	Control group	Subjects in treatment arm	Duration (months)	THI scores pre treatment (w/st. dev.)	THI scores post treatment (w/st. dev.)
Rosenberg et al. (1998)	Melatonin	Placebo (unspecified)	23	1	33.91 (21.57)	26.09 (17.03)
Rejali et al. (2004)	Ginkgo biloba	Placebo (matched tablet)	31	3	37.50 (20.50)	32.80 (18.60)
Petridou et al. (2019)	α‐Lipoic acid	Placebo (sorbitol tablets)	34	3	31.60 (19.30)	25.50 (18.00)
Polanski et al. (2016)	Ginkgo biloba	Placebo (unspecified)	12	6	32.80 (19.90)	34.80 (24.70)
Polanski et al. (2016)	α‐Lipoic acid	Placebo (unspecified)	13	6	38.80 (24.70)	32.50 (25.50)
Oppitz et al. (2022)	Açaí	Placebo (unspecified)	15	3	37.60 (24.80)	27.60 (18.40)
Balatsouras et al. (2024)	MemoVigor 2	Placebo (unspecified)	104	3	33.00 (22.30)	21.40 (21.90)
Khosravi et al. (2022)	Neurotec	Placebo (unspecified)	53	3	58.22 (25.13)	37.52 (20.69)
Portmann et al. (2024)	AUDISTIM	Placebo (unspecified)	59	3	38.90 (16.20)	25.70 (16.00)
Fan et al. (2019)	Cistanche Yishen	“Routine Therapy”	46	1	48.50 (8.20)	25.60 (5.70)

Across the nine included RCTs, several interventions were associated with within‐group reductions in THI scores in their respective treatment arms. For example, MemoVigor 2, AUDISTIM, Neurotec, and Cistanche Yishen granules reported notable decreases in post‐treatment THI scores compared with baseline, whereas some Ginkgo biloba and α‐lipoic acid regimens showed minimal or no change. Placebo groups also frequently demonstrated improvements, particularly in trials with longer follow‐up or adjunctive counseling, underscoring the contribution of nonspecific and expectancy effects. Because of divergent study designs, small sample sizes, and inconsistent reporting of between‐group variance, we did not combine these findings statistically and instead present them in narrative form, supported by Table 1.

4. Discussion

This systematic review of nine randomized controlled trials suggests that several OTC treatments, including Neurotec, AUDISTIM, MemoVigor 2, and Cistanche Yishen granules, may be associated with reductions in tinnitus‐related handicap as measured by the THI. However, these apparent benefits must be interpreted cautiously. For products such as Neurotec, AUDISTIM, MemoVigor 2, and Cistanche Yishen granules, the observed THI improvements originate from single randomized trials; therefore, no firm conclusions can be drawn about true tinnitus handicap benefit. Individual trials were generally small, many interventions were evaluated only once, and placebo groups often showed concurrent improvement. Consequently, the current evidence base is insufficient to support strong conclusions about the magnitude or generalizability of benefit for any specific OTC product.

4.1. Narrative Summaries of Individual Agents and Trials

4.1.1. Melatonin

Melatonin has demonstrated a positive effect on THI scores posttreatment in several studies. Its multifactorial action, including modulation of circadian rhythm, antioxidant properties, and anxiolytic effects, may explain its effect in patients with tinnitus, many of whom report comorbid insomnia and heightened stress. In 2011, Hurtuk et al. conducted a trial evaluating the efficacy of melatonin by using various surveys, like the Tinnitus Severity Index (TSI) and Self Rated Tinnitus (SRT) for example, and found it to be associated with a statistically significant decrease in tinnitus intensity and improved sleep quality for patients with chronic tinnitus [11]. This mostly aligned with previous findings by Megwalu et al. but differed in that they determined that the impact of melatonin on tinnitus was not associated with a decrease in tinnitus volume [12]. In an RCT, Abtahi et al. demonstrated that melatonin 3 mg daily was more effective than sertraline in reducing THI scores, highlighting the therapeutic value of targeting sleep and oxidative stress in tinnitus management [13]. Rosenberg et al. conducted the only trial evaluating melatonin that met our inclusion criteria. This study suggested potential improvement of tinnitus handicap, but there were limitations in methodology and study size, with 30 patients and only 23 fully completing the trial, reducing confidence in its generalizability [14]. While several trials have reported beneficial effects of melatonin for tinnitus, substantial heterogeneity in outcome measures has hindered definitive conclusions.

4.1.2. Ginkgo biloba

The role of Ginkgo biloba is supported by some studies and refuted by others. Several reviews evaluating Ginkgo found no support for the efficacy of Ginkgo biloba treatment; however, some of these reviews combined studies with different Ginkgo biloba preparations without regard to dosage or quality, or included trials that were deemed flawed by some [15, 16, 17]. In 2001, an overview of results from completed clinical trials specifically using Ginkgo special extract EGb 761 reported eight controlled studies on tinnitus that had shown statistically significant effects in treatment compared to placebo [18]. In another study evaluating Ginkgo biloba extract EGb 761 versus pentoxifylline, it was found that both drugs were similarly effective in reducing symptoms for patients with tinnitus, and the Ginkgo group showed more improved effectiveness in those with elevated depression and anxiety scores [19]. Moreover, Morgenstern et al. found that tinnitus patients taking oral Ginkgo special extract EGb 761 followed by a 10‐day infusion experienced a statistically significant moderate decrease in tinnitus volume [20]. Still, other trials, like one conducted by Drew and Davies, report negligible differences compared to placebo, reflecting the inconsistency that has long challenged the clinical adoption of Ginkgo for tinnitus [21]. Although some studies suggest that Ginkgo biloba extract EGb 761 may offer modest benefits for tinnitus, the overall reported effects remain inconsistent, likely due to variability in study quality, Ginkgo extract formulations utilized, and varied patient populations. For those studies included in our analysis, Polanski et al. and Rejali et al. conducted RCTs, with neither finding any significant difference compared to placebo; however, the former used a compounded dry extract of Ginkgo biloba and the latter used a sustained‐release formulation and neither explicitly mentioned the use of a standardized extract that has previously shown some efficacy, like EGb 761 [16, 22]. The inconsistencies in the literature highlight the challenges of drawing firm clinical conclusions and mirror the broader difficulty seen with many alternative tinnitus treatments.

4.1.3. Zinc

Zinc supplementation has produced mixed clinical results. Effects are thought to be related to zinc's role in cochlear and synaptic function. Person et al. reported no significant symptom improvement after 8 weeks of zinc supplementation, and Coelho et al. also demonstrated no improvement in Tinnitus Handicap Questionnaire (THQ) scores after zinc supplementation in the elderly [23, 24]. Conversely, one study found that zinc supplementation elevated serum zinc levels, especially in younger patients, and significantly improved THI scores [25]. Arda et al. also found clinically favorable progress in tinnitus patients receiving zinc, but the improvement was not statistically significant [26]. Although zinc supplementation may offer a biologically plausible mode of treatment, clinical evidence remains inconsistent and no studies were able to meet our inclusion criteria, indicating a need for more robust research methodologies in zinc supplementation evaluation. Overall, most studies have failed to demonstrate a significant benefit to zinc treatment, while other studies report some potential improvements, particularly in younger patients. Generally, findings are limited by small sample size, inconsistent outcome measures between studies, and a lack of consistent statistical significance.

4.1.4. Magnesium

Magnesium supplementation does not have as robust representation in the literature as zinc treatment with regards to treating tinnitus, but one study, Cevette et al., found that magnesium supplementation may improve tinnitus symptoms; however, their sample size is relatively small, and there was no control group [27]. Moreover, magnesium is often included as a component in combination supplements, like Tinnitan Duo, making it challenging to isolate its specific effects.

4.1.5. Antioxidants—α‐Lipoic Acid, açaí, Combination Formulations

Antioxidants were included in the discussion because several of the RCTs meeting our inclusion criteria directly evaluated agents such as α‐lipoic acid, açaí supplementation, or combination formulations containing antioxidant components. That said, the current evidence for antioxidants is inconsistent, and in many cases, these agents were investigated as part of multicomponent supplements, making it difficult to isolate their specific contribution. Their inclusion is therefore justified on methodological grounds but should be interpreted cautiously, as stronger evidence exists for more frequently studied agents such as melatonin and Ginkgo biloba .

Several studies have investigated the potential role of α‐lipoic acid supplementation in the treatment of tinnitus. One 2023 study evaluated α‐lipoic acid in the treatment of chronic tinnitus and found a reduction in THI scores, attributing the improvement to its antioxidant properties; however, the study did not include a placebo control group [28]. One of the studies included in our review, Polanski et al., showed no benefit in THI among the α‐lipoic acid group, while another included study, Petridou et al., showed significant decreases in tinnitus [22, 29]. Animal models suggest that antioxidants, including α‐lipoic acid, may protect against cochlear damage and noise‐induced hearing loss, lending biological plausibility to some of these clinical observations [30, 31].

In 2022, another antioxidant, açaí, was explored by Oppitz et al., and the açaí group showed significant reduction in THI scores; however, the same study showed that the placebo group had significantly decreased Beck Anxiety Inventory scores while the açaí group did not, indicating no meaningful effect for anxiety and raising concerns about possible confounding factors [32]. The current evidence for antioxidants in tinnitus treatment is mixed, and more targeted studies are necessary to determine who, if anyone, might benefit from α‐lipoic acid or açaí supplementation.

Combination antioxidant therapies and herbal blends—such as those used in Fan et al. [33], Khosravi et al. [34], Balatsouras et al. [35], and Portmann et al. [36]—offer a treatment regimen with potential to address the multifactorial etiology of tinnitus. In 2019, Fan et al. evaluated Chinese herb Cistanche Yishen granules in treating tinnitus patients who also had comorbid nephritis. Overall, they reported dramatic improvements in tinnitus symptoms, but the comorbid nephritis in their patient population may limit the generalizability and strength of their findings [33]. Compared to the other included studies, the outlier status of Fan et al. [33], which reported a strikingly high SMD of 3.22, suggests caution; small sample sizes, placebo effects, or publication bias may have inflated effect estimates. Another combination therapy, MemoVigor 2, is a supplement containing phospholipids, l‐acetylcarnitine, Ginkgo biloba , bilberry extracts, various vitamins, and trace minerals, evaluated by Balatsouras et al. It was found to improve recent‐onset tinnitus, although improvements were also observed in the placebo group [35]. Another proprietary supplement, AUDISTIM Day/Night, combines Ginkgo biloba with other antioxidants. Evaluated by Portmann et al., AUDISTIM Day/Night was shown to significantly improve tinnitus symptoms, though the study's commercial sponsorship calls into question the robustness of the findings [36]. Neurotec, an herbal capsule containing extracts of dog‐rose ( Rosa canina ), common nettle ( Urtica dioica ) and tansy (Tana‐cetum vulgare) that was studied by Khosravi et al., was shown to benefit chronic tinnitus patients; however, there was significant patient drop out (27 out of the initial 150) which could affect the internal validity and reliability of the results [34]. Taken together, while combination antioxidant and herbal therapies show potential promise, the current evidence is heterogeneous and methodologically limited, highlighting the need for larger, rigorously designed trials before firm conclusions about efficacy can be drawn.

4.2. Study Limitations, Clinical Implications, and Future Directions

Despite positive trends, the present systematic review is limited by substantial heterogeneity of study design, including broad variation in participant characteristics, intervention type, dosage, and treatment duration. For example, studies used treatment durations ranging from 28 days in Fan et al. to 6 months in Polanski et al. Such inconsistencies limit generalizability and reinforce the need for standardized protocols in future trials. Another limitation was the inability to conduct subgroup analyses by treatment type due to the limited number of eligible trials for each agent. While individual studies evaluated melatonin, Ginkgo biloba , zinc, and various antioxidant formulations, these were too few and heterogeneous to permit meaningful analysis and stratified pooling. For this reason, our discussion of individual therapies should be interpreted as narrative summaries of single‐trial or small‐sample findings rather than definitive subgroup‐level conclusions. This approach underscores both the potential of certain agents and the urgent need for larger, well‐powered RCTs that allow for robust head‐to‐head and subgroup analyses. Another key limitation to generalizability of treatment results is the exclusive reliance on THI as the outcome measure. While the THI remains the most widely validated tool in clinical tinnitus research, it primarily measures perceived distress and may not adequately capture rapid or subtle perceptual changes. Several authors, including Petridou et al. [29] and Khosravi et al. [34], concurrently used the TFI or the VAS, which may be more responsive to short‐term therapeutic changes—especially in pharmacologic or supplement‐based interventions [7]. The small sample sizes and relatively short follow‐up durations across the included studies also limit insights into the long‐term efficacy and safety of OTC treatments. In contrast, long‐term observational studies that were conducted for other therapeutic modalities for tinnitus suggest that behavioral and neuroplastic adaptations may continue beyond the typical RCT window, emphasizing the need for extended follow‐up periods for medication trials [37].

From a clinical perspective, our systematic review findings support that OTC agents should not be recommended as standalone or adjunctive treatments until validated by larger, high‐quality trials. Although some individual trials reported reductions in symptom scores, these findings were inconsistent and difficult to interpret in the absence of replicated results. It should be remembered that while the included studies had to meet very strict criteria for inclusion, there were still limitations and shortcomings found across all studies, emphasizing the need for more substantial and robust research. Although some studies reported ancillary effects such as improved sleep or reduced anxiety, these findings were inconsistent and require further confirmation. Future research should prioritize multicenter, double‐blinded RCTs with rigorous control conditions, standardized dosing, and longer follow‐up periods. Subgroup analyses—by tinnitus subtype (e.g., tonal vs. pulsatile vs. intermittent vs. somatosensory), chronicity, demographics, and comorbidities—are particularly important variables to collect in order to determine which patients are most likely to benefit from which supplement. Moreover, innovative trial designs, such as crossover studies and N‐of‐1 trials, may help mitigate interindividual variability and clarify patient‐level response predictors.

In sum, OTC therapies have not demonstrated reliable or generalizable benefit, and current evidence is insufficient to determine whether they provide clinically meaningful effects. Their affordability and accessibility may explain why patients frequently seek these products; however, current evidence is insufficient to determine whether they provide meaningful therapeutic benefit. The field of tinnitus treatment research would benefit from a unified study paradigm to consolidate evidence, guide clinical decision making, and ultimately improve outcomes for the millions affected by this complex condition.

5. Conclusion

This systematic review of RCTs demonstrated that individual trials evaluating OTC treatments such as melatonin, Ginkgo biloba , magnesium‐containing formulations, antioxidants, and multicomponent herbal blends reported improvements in THI scores; however, these isolated findings cannot establish clinical efficacy. At present, no OTC therapy can be recommended as an evidence‐based treatment for tinnitus, either alone or as an adjunct. Rigorous, adequately powered RCTs with standardized THI and complementary outcome measures are needed to clarify efficacy and guide clinical recommendations.

Funding

The authors have nothing to report.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Table S1: Search strategy terms used for the literature review, organized by general terms and database‐specific controlled vocabulary for PubMed and Embase.

Table S2: Inclusion and exclusion criteria used for study selection, including population, intervention, comparator, outcome, and study design characteristics.

Table S3: Risk of bias assessment of included randomized controlled trials across individual RoB domains, including randomization, deviations from intended interventions, missing outcome data, outcome measurement, selection of reported results and overall risk of bias.

Table S4: Narrative rationale supporting the risk of bias judgments for each included study.

Data Availability Statement

The data that support the findings of this study are openly available in OTC Tinnitus Treatments Meta Analysis Data at https://osf.io/svzat/?view_only=78cf4ec20b0245e0bb4130636efb3e28.