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The patient may have an undermethylation pattern, overmethylation, elevated SAH, copper overload, low zinc, pyroluria, medication sensitivity or another biochemical impediment

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A double-blind, randomized, placebo-controlled crossover study of memantine monotherapy (60 patients, 43 completed) found no significant improvement in Tinnitus Handicap Inventory scores compared with placebo, leading the authors to conclude that the study does not provide evidence to recommend memantine for tinnitus treatment (Figueiredo et al., 2008)