Menière's disease and diphenidol. A critical analysis of symptoms and equilibrium function tests

In 24 patients with Ménière's disease, chemotherapy using Diphenidol (1,1-diphenyl-4-piperidino-l-butanol hydrochloride), a non-phenothiazinic antiemetic agent, was carried out using the double-blind technique in the cross-over design. The prevalence and intensity of symptoms at the three stages were recorded every three weeks according to fixed scales which were graded: vertigo, unsteadiness, tinnitus, nausea, headache, and shoulder stiffness. The hearing was measured by tone audiometry. Equilibrium function tests were also performed every three weeks and these included the electronystagmographical procedure to determine caloric response and the ARG-Tilt tests. Both symptoms and the results of equilibrium function tests, showed a higher incidence of improvement during the period of Diphenidol administration than during that of placebo. The difference was statistically significant with respect to vertigo, dizziness or unsteadiness, and general condition subjectively, as well as caloric response and ARG-Tilt tests. The Diphenidol effect consisted of an improvement of imbalance, both in the peripheral and in the central vestibular system through its neural and circulatory action. Only 8% of the patients dropped out and no side effects were observed in this series. Both the feasibility of the graded symptom scales and the utility of each parameter obtained from the equilibrium function tests are discussed in connection with testing of the drug in various stages of the disease.