Repetitive transcranial magnetic stimulation for tinnitus treatment: No enhancement by the dopamine and noradrenaline reuptake inhibitor bupropion

Background Repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex has shown beneficial effects in patients with chronic tinnitus. Recent preclinical data in healthy controls suggest that the effects of low-frequency rTMS can be enhanced by dopaminergic drugs. Objective We investigated whether application of the dopamine reuptake inhibitor bupropion increases the clinical effects of low-frequency rTMS over the auditory cortex in tinnitus patients. Subjects and Methods Eighteen subjects with chronic tinnitus received 10 sessions of 1 Hz rTMS (2000 pulses/day, 110% motor threshold) applied to the left temporal cortex. In addition, these subjects received one dosage of 150 mg bupropion (Wellbutrin XL/Elontril) 4 hours before each TMS session. Treatment outcome was assessed with a tinnitus questionnaire over a 3-month period. Treatment effects were compared with a control group of 100 tinnitus patients matched for age, tinnitus duration, and tinnitus questionnaire baseline scores, who received the same rTMS treatment without prior bupropion application. Results For the whole sample, there was a significant effect of rTMS treatment over time. There were no significant differences between the bupropion and the control group. Conclusions Our data suggest that 150 mg bupropion administration does not enhance the effect of rTMS in the treatment of tinnitus.