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Ménière's disease
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=== Medications === During MD episodes, [[antiemetics|medications to reduce nausea]] are used, as are [[anxiolytics|drugs to reduce the anxiety]] caused by vertigo.<ref name=See2016/><ref name=Foster2015rev/> For longer-term treatment to stop progression, the evidence base is weak for all treatments.<ref name=See2016/> Although a causal relation between allergy and Ménière's disease is uncertain, [[Allergy#Management|medication to control allergies]] may be helpful.<ref name="Allergy2014rev">{{Cite journal|last1=Weinreich|first1=Heather M.| last2= Agrawal|first2=Yuri|date=June 2014|title=The Link Between Allergy and Menière's Disease|journal=Current Opinion in Otolaryngology & Head and Neck Surgery |volume= 22 |issue= 3|pages=227–230|doi=10.1097/MOO.0000000000000041|issn=1068-9508|pmc=4549154|pmid=24573125}}</ref> To assist with vertigo and balance problems, [[glycopyrrolate]] has been found to be a useful vestibular suppressant in patients with Ménière's disease.<ref name= storper108-10>{{Cite journal |pmid = 9778280|year = 1998|last1 = Storper|first1 = Ian S.|last2 = Spitzer|first2 = Jaclyn B.|last3 = Scanlan|first3 = Mark |title = Use of glycopyrrolate in the treatment of Meniere's disease|journal = The Laryngoscope|volume = 108|issue = 10|pages = 1442–1445|doi = 10.1097/00005537-199810000-00004|s2cid = 39137575}}</ref> [[Diuretics]], such as the thiazide-like diuretic [[chlortalidone]], are widely used to manage MD on the theory that it reduces fluid buildup (pressure) in the ear.<ref>{{Cite journal|last1=Thirlwall|first1=A. S.|last2=Kundu|first2=S.|date=2006-07-19|title=Diuretics for Ménière's disease or syndrome|journal=The Cochrane Database of Systematic Reviews|volume=2010 |issue=3|pages=CD003599|doi=10.1002/14651858.CD003599.pub2|issn=1469-493X|pmid=16856015|pmc=9007146 }}</ref> Based on evidence from multiple but small clinical trials, diuretics appear to be useful for reducing the frequency of episodes of dizziness but do not seem to prevent hearing loss.<ref>{{Cite journal|last1=Crowson|first1=Matthew G. |last2= Patki |first2= Aniruddha |last3= Tucci| first3=Debara L.|date=May 2016|title=A Systematic Review of Diuretics in the Medical Management of Ménière's Disease|journal=Otolaryngology–Head and Neck Surgery|volume=154|issue=5|pages=824–834|doi=10.1177/0194599816630733|issn=1097-6817|pmid=26932948|s2cid=24741244}}</ref><ref name="pmid31046134">{{cite journal| author=Stern Shavit S, Lalwani AK| title=Are diuretics useful in the treatment of meniere disease? | journal=Laryngoscope | year= 2019 | volume= 129 | issue= 10 | pages= 2206–2207 | pmid=31046134 | doi=10.1002/lary.28040 | doi-access=free }}</ref> In cases where hearing loss and continuing severe episodes of vertigo occur, a [[chemical labyrinthectomy]], in which a medication such as [[gentamicin]] is injected into the middle ear and kills parts of the vestibular apparatus, may be prescribed.<ref name=See2016/><ref name=Pul2011>{{cite journal |last1=Pullens |first1=B |last2=van Benthem |first2=PP |title= Intratympanic gentamicin for Ménière's disease or syndrome. |journal=The Cochrane Database of Systematic Reviews |date=16 March 2011 |issue=3 |pages=CD008234 |doi= 10.1002/14651858.CD008234.pub2 |pmid=21412917}}</ref><ref name="PMID22699980">{{Cite journal|last1=Huon|first1=Leh-Kiong|last2=Fang|first2=Te-Yung|last3=Wang|first3=Pa-Chun |date= July 2012| title=Outcomes of intratympanic gentamicin injection to treat Ménière's disease|journal=Otology & Neurotology |volume=33|issue=5|pages=706–714 |doi= 10.1097/MAO.0b013e318259b3b1| pmid= 22699980 |s2cid= 32209105}}</ref> This treatment has the risk of worsening hearing loss.<ref name=Pul2011/>
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