There is no cure for Ménière's disease, so treatment focuses on managing symptoms.
Different types of medications may be used to control various symptoms, including:
Anti-vertigo medications, such as meclizine (Antivert or Bonine) or betahistine, to relieve or prevent vertigo and dizziness
Antinausea medications, such as prochlorperazine (Compazine), to relieve nausea and vomiting
Diuretics, such as hydrochlorothiazide (HydroDIURIL), to reduce the amount of fluid that builds in the inner ear
Many physicians also recommend avoiding caffeine, alcohol, salt and nicotine to reduce the frequency or severity of attacks. These lifestyle changes may or may not help, but they are worth trying.
In severe cases, your doctor may recommend injections of gentamicin into the middle ear. A side effect of gentamicin (a potent intravenous antibiotic) is damage to the balance mechanism inside the ear. By selectively destroying the balance part of the ear, the condition may actually improve. Single to multiple injections may be necessary to damage the inner ear enough to stop the vertigo episodes. The injections can be performed in the office.
Your doctor may recommend surgery if symptoms of vertigo are severe or frequent. Different surgical procedures are available, each with pros and cons. For example, some types of surgery require your doctor to destroy parts of the inner ear, which can cause permanent hearing loss. If you are considering surgery, be sure to talk to your doctor about the possible risks and benefits. Surgical procedures that may be recommended in severe cases include:
Selective vestibular neurectomy, in which the nerve that runs from the inner ear to the brain is cut
Endolymphatic shunt, in which a tiny hole is cut in the inner ear to help clear out some of the accumulated fluid
No treatment can prevent the hearing loss that occurs in Ménière's disease.