The pharmacological management of vertigo in Meniere disease

Expert Opinion on Pharmacotherapy
J M Espinosa-Sanchez, J A Lopez-Escamez

Abstract

The term Meniere disease (MD) gathers a set of rare diseases involving the inner ear characterized by episodic vertigo associated with fluctuating auditory symptoms. Five clinical subgroups of patients have been defined, including familial MD, autoimmune MD, and MD with migraine. The diagnosis is based on clinical criteria as no biomarker is available, but genetic factors have a significant contribution in familial and non-familial MD. In this review, the authors summarize the pharmacological treatment for vertigo in MD, providing evidence from preclinical and clinical studies. However, evidence supporting the efficacy for betahistine, diuretics, and intratympanic administration of corticosteroids or gentamicin is limited. Randomized clinical trials should consider stratification by MD clinical subgroups. The treatment plan should be personalized according to the clinical subgroup, hearing stage, duration of the disease, vertigo attack profile, and comorbidities. The treatment should include therapeutic counseling, sodium-free diet, high-water intake, and a diary of vertigo attacks with symptoms during the episodes to improve phenotyping. Migraine or autoimmune comorbidities will also require pharmacotherapy. Genetic testing by...Continue Reading

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Citations

Jun 24, 2021·Drugs & Aging·Augusto Pietro CasaniSilvia Capobianco
Jul 25, 2021·Otolaryngologic Clinics of North America·Christine LittleMaura K Cosetti
Jan 22, 2022·Expert Review of Neurotherapeutics·Sulin ZhangWeijia Kong

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