Pharmacotherapy of meniere's disease: A review

Meniere's disease (MD) is a chronic inner ear disorder characterized by intermittent episodes of vertigo lasting from minutes to hours, with fluctuating sensorineural hearing loss, tinnitus, and aural fullness. Endolymphatic hydrops is thought to be the pathological basis for MD and arise due to either excessive production or inadequate absorption of endolymph. The raised endolymphatic pressure causes periodic rupture or leakage in the membrane separating the endolymphatic from perilymphatic space. So, the treatment aims to reduce the production and increased the absorption of endolymph. The clinical objective of treatment is to stop vertigo spells, reduce or abolish tinnitus and preserve or even reverse hearing loss. The majority of the studies have focused on reducing vertigo attacks, which is the severest symptom of MD. There are several therapeutic options for MD, but none is considered effective by the scientific community. The prerequisites for successful pharmacotherapy for MD include correct diagnosis, correct drug, appropriate dosage, and appropriate duration of therapy. There are several groups of drugs that can be used for MD such as betahistine, oral corticosteroids, intratympanic corticosteroids, intratympanic gentamycin injections, and benzodiazepines. The objective of this review article is to discuss the current knowledge of the pharmacotherapy of MD. Appropriate treatment of MD prevents this morbid disease and improves the quality of life.