Assessing the Efficacy of a Serotonin and Norepinephrine Reuptake Inhibitor for Improving Meniere's Disease Outcomes

Inclusion Criteria

• •be 18 years of age or older;
• •have definite MD as defined by the Barany Society 2015 international consensus statement;
• •have active MD with at least 2 vertigo episodes in the month prior to enrollment; and score at least 36 on the Dizziness Handicap Inventory (DHI), representing at least moderate handicap.
• •Patients with the following will be excluded:
• •other concurrent vestibular or balance disorder (especially those with vestibular migraine-related vertigo episodes despite not meeting diagnostic criteria for vestibular migraine);
• •currently taking venlafaxine, SSRIs, or SNRIs;
• •history of medical (e.g. gentamicin) or surgical (e.g. labyrinthectomy) vestibular ablative treatment;
• •history of otologic, lateral skull base, or brain surgery;
• •history of radiation to the head or neck;
• •known neurologic disorder affecting cognition;
• •currently taking another serotonin modulating medication;
• •seizures;
• •stroke;
• •myocardial infarction;
• •hepatic or renal impairment;
• •hyperlipidemia;
• •coagulopathy;
• •psychiatric disorder other than anxiety or depression;
• •glaucoma;
• •uncontrolled hypertension;
• •pregnancy or intention of pregnancy.