Ménière’s disease is a chronic inner ear disorder that can significantly impact a person’s quality of life. Characterized by unpredictable episodes of vertigo, fluctuating hearing loss, tinnitus (ringing in the ear), and a sensation of fullness in the affected ear, the condition can be debilitating. Patients often struggle with daily activities due to the unpredictability of symptoms, making choosing the right medication essential.
One medication that has gained attention for addressing balance disorders like Ménière’s disease is betahistine, a histamine analog that helps regulate inner ear fluid levels. Betahistine is widely prescribed in Europe and Canada and is available in Michigan through Healthway Compounding Pharmacy in Saginaw, MI.
This article explores how betahistine is used, who may benefit from it, and how Michigan ENT health providers prescribe it.
Understanding Ménière’s Disease and Balance Disorders
Ménière’s disease affects an estimated 615,000 people in the U.S., with about 45,500 new cases diagnosed each year.
Source: National Institute of Deafness and Other Communication Disorders
Ménière’s Disease most commonly affects adults between 40 and 60 years old, but younger and older individuals can also develop the condition.
The exact cause remains unknown, but it is linked to abnormal fluid buildup in the inner ear (endolymphatic hydrops). This buildup affects the vestibular system, which controls balance, leading to vertigo attacks that can last minutes to hours.
Ménière’s disease is just one of several balance disorders that providers prescribe betahistine for. Other conditions include:
- Vestibular migraines – Chronic migraines that cause dizziness and balance problems.
- Labyrinthitis and vestibular neuritis – Inner ear infections that can result in prolonged dizziness.
- Ototoxicity-related balance disorders – Inner ear damage due to medications like certain antibiotics or chemotherapy drugs.
Patients suffering from these conditions often face significant mobility issues, anxiety, and difficulty performing daily tasks due to the unpredictability of symptoms. Symptom management is crucial for maintaining quality of life.
How Betahistine May Help
Betahistine is a histamine H1 agonist and H3 antagonist that is thought to improve microcirculation in the inner ear by increasing blood flow and reducing pressure in the endolymphatic sac. This effect may help relieve vertigo symptoms by stabilizing fluid balance.
“The action of histamine on the vestibular cells on the affected side may contribute to a rebalancing of neuronalactivity between the two sides; a key mechanism in the vestibular recovery process.”
Source: Neuropsychiatric Disease and Treatment
Potential benefits of betahistine for Ménière’s and balance disorders include:
- Reduction in vertigo frequency and severity
- Improved inner ear circulation
- Potential hearing preservation
- Minimal side effects compared to other vestibular suppressants
Betahistine is typically prescribed in doses ranging from 24 mg to 48 mg per day, divided into multiple administrations. However, higher doses (up to 144 mg per day) have been studied for patients with severe, drug-resistant Ménière’s disease.
Scientific Studies on Betahistine
Several studies have explored the efficacy of betahistine in managing Ménière’s disease, particularly concerning vertigo symptoms. Here are some pertinent findings:
- A meta-analysis of 12 double-blind, randomized, placebo-controlled clinical studies concluded:
“Our meta-analysis supports the therapeutic benefit of betahistine on vertiginous symptoms in both Ménière’s disease and vestibular vertigo.”
- A systematic review assessing betahistine’s impact on Ménière’s disease reported:
“One study with a low risk of bias found no significant difference between the betahistine groups and placebo with respect to vertigo after a long-term follow-up period.”
- A clinical trial comparing high-dose betahistine (288–480 mg/day) in patients with severe Ménière’s disease found:
“The frequency and the severity of vertigo were significantly reduced in all patients.”
Many ENT specialists, neurologists, and vestibular rehabilitation therapists continue to recommend betahistine for balance disorder management, particularly when other therapies fail.
Who Uses Betahistine?
Betahistine is primarily prescribed for:
- Ménière’s Disease Patients
- People experiencing frequent vertigo attacks affecting their ability to work or drive.
- Patients looking for an alternative to vestibular suppressant drugs like meclizine or benzodiazepines, which can cause drowsiness.
- Those who have tried dietary and lifestyle changes (such as a low-sodium diet) with limited success.
- Patients with Chronic Dizziness or Balance Disorders
- Older adults suffering from vestibular dysfunction leading to frequent falls.
- Individuals experiencing dizziness due to labyrinthitis, vestibular neuritis, or vestibular migraines.
- People Recovering from Inner Ear Infections or Surgery
- Patients recovering from vestibular schwannoma (acoustic neuroma) surgery.
- Those with ototoxicity-related damage looking for symptom relief.
Who Prescribes Betahistine in Michigan?
Betahistine is not available at standard commercial pharmacies. However, it can be legally prescribed and compounded by specialized pharmacies like Healthway Compounding Pharmacy in Saginaw, Michigan.
Practitioners who prescribe betahistine include:
- Michigan ENT (Ear, Nose, and Throat) specialists – Often the first to diagnose Ménière’s disease.
- Neurologists – May prescribe betahistine for vestibular migraines or other neurological balance disorders.
- Vestibular rehabilitation therapists (in collaboration with physicians) – Recommend betahistine as part of a balance therapy program.
- Primary care physicians – Prescribe it for patients experiencing chronic dizziness.
At Healthway Compounding Pharmacy, betahistine is custom-formulated in different strengths and dosages to meet individual patient needs. As the first PCAB-accredited compounding pharmacy in Michigan (since 2007), Healthway ensures high-quality formulations.
Supporting Michigan ENTs with Trusted Medication Compounding
Betahistine remains a popular choice among ENT specialists and neurologists worldwide.
For Michigan patients, Healthway Compounding Pharmacy in Saginaw offers customized betahistine formulations, providing patients with an alternative option for managing vertigo and balance disorders. If you suffer from chronic dizziness or Ménière’s disease, speak with your healthcare provider about whether betahistine may be right for you.
For Michigan practitioners, reach out to our pharmacists and let’s talk about how we can provide your patients with innovative options.
References
Lacour, M., van de Heyning, P. H., Novotny, M., & Tighilet, B. (2007). Betahistine in the treatment of Ménière’s disease. Neuropsychiatric Disease and Treatment, 3(4), 429–440.
Lezius, F., Adrion, C., Mansmann, U. et al. High-dosage betahistine dihydrochloride between 288 and 480 mg/day in patients with severe Menière’s disease: a case series. Eur Arch Otorhinolaryngol 268, 1237–1240 (2011). https://doi.org/10.1007/s00405-011-1647-2
Rubén Ramos Alcocer, José Gregorio Ledezma Rodríguez, Antonio Navas Romero, José Luis Cardenas Nuñez, Vicente Rodríguez Montoya, Jose Junior Deschamps & Jorge Anibal Liviac Ticse. (2015) Use of betahistine in the treatment of peripheral vertigo. Acta Oto-Laryngologica 135:12, pages 1205–1211.