Meniére's Disease and Hydrochlorothiazide (Dichlotride®)—A Critical Analysis of Symptoms and Therapeutic Effects

Abstract

In 50 cases of Menière's disease, a diuretic, Dichlotride® (hydrochlorothiazide), was administered orally with the object of reducing the electrolyte disturbance and endolymphatic hydrops that can be presumed to be of pathogenetic importance. A pilot study was made in 20 cases. No effect was noted in cases in which the disease was in a late stationary stage, with non-fluctuating hearing loss of the “flat loss” type. In cases in which the disease still had a bout-like or fluctuating course, an improvement was obtained in connexion with therapy, but the results were inconclusive, in view of the greatly varying spontaneous course. A second treatment series was therefore carried out, using the double-blind technique, in 30 cases of the fluctuating type. The prevalence and intensity of the symptoms were recorded monthly. The hearing was measured by tone audiometry, whereas tinnitus, vertigo and general condition were graded according to fixed scales. All symptoms, as well as the general condition, showed a higher incidence of improvement during the period of Dichlotride administration than during that of placebo. The difference was statistically significant with respect to hearing loss, vertigo and general condition. The Dichlotride effect consisted of a reduction in the symptoms during the course of treatment, but no indications were present of a change in the long-term course of the disease. No side-effects were observed, and potassium substitution was unnecessary with the schedule used.