Optimizing the pharmacological component of integrated balance therapy.
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.
Ganança
Maurício Malavasi
MM
Federal University of São Paulo, São Paulo, Brazil. mauricio.gananca@globo.com
Caovilla
Heloisa Helena
HH
Munhoz
Mário Sérgio Lei
MS
Ganança
Cristina Freitas
CF
da Silva
Maria Leonor Garcia
ML
Serafini
Flavio
F
Ganança
Fernando Freitas
FF
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
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