Effects of Selective Seratonine Re-Uptake Inhibitors on Meniere's Disease
The Journal of International Advanced Otology
Clinical Report Pathogenesis of the Meniere's disease (MD) is still unclear and there is no particular treatment directed to the etiology of this disease [1, 2] . Many medical treatment options are available for MD, which include benzodiazepines, betahistine, diuretics, steroids, and even antidepressants. Selective serotonin re-uptake inhibitors (SSRIs) have been used for treatment of anxiety and depression  . SSRIs have many advantages including good tolerability, easy prescription, and low
... complication rates. It has been reported that SSRIs improved dizziness in patients with different psychiatric symptoms, including peripheral vestibular symptoms and migraine headaches  . There are case reports on the beneficial effects of SSRIs on MD. In one of these reports, it is speculated that SSRIs may have treated associated morbidity such as migraine-associated vertigo or associated panic disease but not MD itself. Vertigo attacks were improved by the application of sertraline on patients with MD  . Our aim was to evaluate the effects of SSRIs on patients who have both MD and generalized anxiety disorder. The high control rates of real Meniere's attacks in our series suggest that SSRIs might have a direct effect on the vestibular system and its central connections besides controlling the associated panic disorder. OBJECTIVE: To evaluate the effects of selective serotonin re-uptake inhibitors (SSRIs) on Meniere's disease (MD) on patients who have both MD and generalized anxiety disorder. MATERIALS and METHODS: All patients were evaluated with neurotologic examination, videonystagmography, audiological tests, and inner ear magnetic resonance imaging. Characteristic history and the evaluation of the patients' vertigo attacks during the attacks were the primary criteria for the diagnosis of MD. According to these parameters, 12 patients were diagnosed with definite MD and also symptoms of generalized anxiety disorder. Escitalopram 10 mg was prescribed to the patients. The clinical records of these patients were reviewed. RESULTS: Eight female and 4 male patients with MD and generalized anxiety disorder were included. The average age was found to be 46.25 years (34-63 years). Magnetic resonance imaging of patients was reported as normal. All patients had unilateral MD. The patients were diagnosed with MD for 2-12 years (mean: 5 years). All patients used betahistine and diuretics before escitalopram. Intratympanic gentamicin was also applied to one patient. After escitalopram medication, no vertigo attack was observed in any of the patients. CONCLUSION: SSRIs may have a central balancing effect on vertigo attacks of MD. Escitalopram can control vertigo attacks in MD. Further studies are needed to support this effect.