[Long-term therapy of Ménière's disease. Comparison of the effects of betahistine dihydrochloride and hydrochlorothiazide].

During the last few years betahistine-dihydrochloride has been used extensively in the conservative treatment of M. Ménière. The question has arisen as to whether betahistine-dihydrochloride is more effective than diuretics. The effect of betahistine-dihydrochloride was compared to that of hydrochlorothiazide on 32 M. Ménière-patients. The patients were initially kept under observation for 3 months without medication apart from symptomatic anti-vertigo agents. The patients were then assigned to 2 groups each of 16 subjects and received either 3 X 8 mg betahistine-dihydrochloride or 3 X 25 mg hydrochlorothiazide for 6 months under double-blind conditions. Before and during treatment subjective symptoms such as vertigo, attacks of dizziness, tinnitus, sensation of blockage in the ear and general well-being were assessed at 4-weekly intervals. Apart from this the objective symptoms as measured by pure tone audiograms, Frenzel-test and electronystagmography were recorded. At the moment betahistine-dihydrochloride seems to be the drug of choice for Ménière-patients with a fluctuating auditory threshold. During the 6 months treatment period an impressive reduction in the frequency, severity and duration of the attacks of vertigo as well as an improvement in the general condition was found in all patients. In contrast the diuretic hydrochlorothiazide seemed to show a distinct therapeutic effect on vertigo and general well-being principally during the first few months of treatment in patients with a constant auditory threshold.