Clinical Research Directory

Inclusion Criteria: * Age 18 years or older * Non-pulsatile, subjective tinnitus present for at least 6 months * Tinnitus Functional Index (TFI) score greater than 25 at screening, indicating at least mild-to-moderate tinnitus burden * Current or past history of migraine, vestibular migraine, or episodic headache disorder, diagnosed by a physician or meeting ICHD-3 criteria * Clinically appropriate candidate for migraine preventive therapy as determined by the treating clinician * Stable medication regimen for at least 3 months prior to enrollment (no new medications started or stopped within 3 months of screening) * Ability to provide written informed consent * Ability to complete self-report questionnaires in English or with certified interpreter assistance * Willingness to attend three in-person study visits over 24 weeks and complete daily symptom diaries Exclusion Criteria: * Pulsatile tinnitus or objective tinnitus (tinnitus audible to examiner) * Pregnancy, planned pregnancy during the study period, or breastfeeding * Participation in any other interventional tinnitus treatment research protocol during the study period * Currently receiving a CGRP-targeting medication (for participants being considered for the conventional arm) or a conventional migraine preventive medication listed in this protocol (for participants being considered for the CGRP arm) - to avoid within-arm ineligibility at randomization * Known contraindication to all medications within the assigned study arm * History of serious cardiovascular event (myocardial infarction, stroke, or unstable angina) within 6 months of enrollment * Severe hepatic or renal impairment that would contraindicate study medications * Active psychiatric disorder requiring medication adjustment within 3 months of enrollment * Known hypersensitivity or prior serious adverse reaction to a medication within the assigned study arm * Active malignancy or life expectancy less than 12 months * Inability to complete study procedures or follow-up visits in the judgment of the investigator