title: Optimizing the pharmacological component of integrated balance therapy.
abstract: Drug treatment is an important option for the treatment of peripheral vestibular diseases.
  
  
  OBJECTIVE
  To identify the drug component associated with optimal integrated balance therapy (IBT) for Ménières disease or other peripheral vestibular disorders.
  
  
  METHODS
  Analysis of a series of patients with Ménières disease patients or patients with other peripheral vestibular disorders that received IBT involving either no medication or betahistine, cinnarizine, clonazepam, flunarizine or Ginkgo biloba during 120 days.
  
  
  RESULTS
  In Ménières disease, significant differences were observed for all drug therapies (60 days) versus no medication; betahistine was significantly more effective than all other drugs at 60 and 120 days. For non-Ménières disorders, significant differences were observed among betahistine, cinnarizine, clonazepam and flunarizine and no medication after 60 days; all drug therapies were significantly more effective than no medication after 120 days; betahistine, cinnarizine or clonazepam were equally effective and betahistine was more effective than flunarizine and EGb 761. All treatment options were well tolerated.
  
  
  CONCLUSIONS
  Drug therapies were more effective than no medication in the IBT for patients with Ménières disease or other peripheral vestibular disorders. Betahistine was the most effective medication for patients with Ménières disease and was as effective as cinnarizine and clonazepam for other peripheral vestibular disorders.
authors.affiliation: Federal University of São Paulo, São Paulo, Brazil. mauricio.gananca@globo.com
authors.forename: Maurício Malavasi
authors.initials: MM
authors.lastname: Ganança
authors.forename: Heloisa Helena
authors.initials: HH
authors.lastname: Caovilla
authors.forename: Mário Sérgio Lei
authors.initials: MS
authors.lastname: Munhoz
authors.forename: Cristina Freitas
authors.initials: CF
authors.lastname: Ganança
authors.forename: Maria Leonor Garcia
authors.initials: ML
authors.lastname: da Silva
authors.forename: Flavio
authors.initials: F
authors.lastname: Serafini
authors.forename: Fernando Freitas
authors.initials: FF
authors.lastname: Ganança
mesh_terms: D001621:Betahistine / Q000627:therapeutic use; D002936:Cinnarizine / Q000627:therapeutic use; D002998:Clonazepam / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D005444:Flunarizine / Q000627:therapeutic use; D020441:Ginkgo biloba; D017442:Histamine Agonists / Q000627:therapeutic use*; D006634:Histamine H1 Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy / Q000628:therapy*; D008875:Middle Aged; D010936:Plant Extracts / Q000627:therapeutic use; D016896:Treatment Outcome; D015837:Vestibular Diseases / Q000188:drug therapy / Q000628:therapy*; D000096983:Ginkgo Extract
chemical_list: D001621:Betahistine; D002936:Cinnarizine; D002998:Clonazepam; D005444:Flunarizine; D017442:Histamine Agonists; D006634:Histamine H1 Antagonists; D010936:Plant Extracts; C063170:Ginkgo biloba extract; D000096983:Ginkgo Extract