1993 Volume 86 Issue 4 Pages 499-507
Isosorbide, an osmotic diuretic, has been used in the medical treatment of Meniere's disease since Kitahara et al first described it in 1980. Since then, there have been several reports on the efficacy of this drug for Meniere's disease, but there have been few long-term clinical evaluations.
The long-term therapeutic effect of Isosorbide was evaluated clinically in 19 patients (9 males and 10 females) followed in our clinic for more than 2 years. Isosorbide was given orally continuously or intermittently for 27 to 183 weeks, depending on each patient's condition. The effectiveness of the drug was determined by the AAOO and AAO-HNS evaluation criteria.
Definite dizzy spells were successfully controlled in 8 (73%, according to the AAOO criteria) or 9 (82%, according to the AAO-HNS criteria) of the 11 patients who received Isosorbide continuously, and in 6 (75%, according to both criteria) of the 8 patients given the drug intermittently. Hearing improved in 4 (21%) and tinnitus was reduced in 9 (47%). Among the patients who responded well to treatment, the dosage of Isosorbide could be tapered to a daily dose of 21g (30ml), less than one-third of the usual daily dose of this drug, but in a few patients episodes of vertigo were not well controlled despite continuous medication for more than 6 months.
These results suggest that most patients should continue medical management for several months before a decision can be made that the medical response is good or poor and that the long-term use of Isosorbide is offen effective in stabilizing the disabling symptoms of Meniere's disease.
