A Pill for Meniere's

Although Meniere's disease claims hundreds of thousands of victims in the U.S. alone, it is not really a disease at all. It is a group of symptoms that have defied both explanation and effective treatment. However it is labeled, the disorder usually starts with a ringing in the ears (tinnitus), followed by impaired hearing, spells of dizziness accompanied by unbearable nausea, and severe vomiting. Meniere's, named for French Physician Prosper Meniere (1799-1862) who first described it, is so distressing that doctors are eager to try anything that will give their patients a measure of relief. Some get help from drugs, including histamine solutions, which have to be infused into a vein; others are subjected to drastic surgical procedures.

Now a new theory not only seems to offer a satisfactory explanation of the origins of Meniere's disease, but has also led to the development of an oral drug that appears to control the symptoms. The theory is that Meniere's begins with an accumulation of lymph fluids in the inner ear, apparently as the result of changes in circulation. The excess lymph, which causes the tinnitus and dizziness, can be dissipated by restoring this "microcirculation." Histamine, one of the body's cellular hormones, will do the job, but it is so powerful that it must be used with great care.

The Mayo Clinic's Dr. Bayard T. Horton began the search for something that would be gentler in action and effective when taken by mouth. His chemist collaborators found betahistine dihydro-chloride, now manufactured under the trade name Sere by New Jersey's Unimed, Inc. Just approved for general prescription, Sere has already been taken by 14,000 patients under the care of almost 300 physicians. Because Meniere's symptoms come and go unpredictably, evaluation of any treatment is a long and tedious process. But in a careful double-blind study, in which neither doctor nor patient knew which was the drug and which was the dummy sugar pill, Dr. Joseph C. Elia of Reno reported excellent results. Three-fourths of the time, the patients on the drug enjoyed relief from dizziness, nausea and headache; the tinnitus response was not so uniform, but still substantial.

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