Meniere's treatment separates into managing an acute attack, usually with vestibular suppressants and anti-nausea medication for a short period, and reducing attack frequency, where diuretics and dietary sodium restriction are the usual approach. Vestibular suppressants are for the attack itself rather than continuous use, because prolonged use interferes with the brain's compensation.
Meniere's treatment separates into managing an acute attack, usually with vestibular suppressants and anti-nausea medication for a short period, and reducing attack frequency, where diuretics and dietary sodium restriction are the usual approach. Vestibular suppressants are for the attack itself rather than continuous use, because prolonged use interferes with the brain's compensation.
Vestibular suppressants such as meclizine and anti-nausea medications including prochlorperazine or ondansetron reduce the severity of vertigo and vomiting during an attack, and a benzodiazepine is sometimes used for severe episodes. The important qualifier is duration: these are for the attack itself and short periods, not continuous use, because prolonged use interferes with the brain's compensation and adds sedation and falls risk.
Dietary sodium restriction and a diuretic are the usual first approach, aiming to reduce fluid pressure in the inner ear. Betahistine is used in many countries and is not available in the same way in the United States. Where attacks continue despite this, intratympanic injections of corticosteroid or gentamicin into the middle ear are options, and gentamicin carries a risk of hearing loss that has to be weighed deliberately. Those procedures are arranged with an appropriate specialist.
None of this reverses the condition or reliably protects hearing, and being honest about that matters. Hearing in the affected ear tends to decline over years regardless, which is why audiology follow-up is part of ongoing care. Reassuringly, attack frequency often decreases over time in many people. Vestibular rehabilitation helps with the unsteadiness that persists between attacks, and that is where prolonged suppressant use actively works against you.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: dizziness and vertigo; MedlinePlus, National Library of Medicine; National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.