A Prospective Trial of Sertraline for Chronic Subjective Dizziness

Abstract

Sertraline significantly reduced chronic subjective dizziness in patients without active physical neurotologic illness, including those with and without psychiatric comorbidity.

Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society

“…This clinical diagnosis was similar in many ways to PPV, but focused primarily on physical not psychological symptoms. Table 1 Features of PPV, SMD, VV, and CSD that informed the definition of PPPD PPV [13] SMD [39] VV [15] CSD [79,81] Primary Symptoms (criteria A. [76] Included in the definition of CSD were persistent nonvertiginous dizziness or unsteadiness, heightened sensitivity to motion of self or objects in the environment, and difficulty performing tasks that required precise visual focus.…”

“…Smaller visual targets (e.g., books, mobile electronic devices) may be troublesome when held at a close distance. Performing tasks that require precision visual focus (e.g., using a computer, or watching television) may exacerbate symptoms even when patients are sitting still [75,79,81]. The increasing need to view information on electronic screens in the modern world is a bane for many patients with PPPD.…”

“…Postural provocation is a distinguishing feature of PPV [12,13]. It was not part of the original description of CSD [81], but was added later [75]. Difficulty with self-motion is part of PPV [12,13], SMD [39], and CSD [75,81].…”

“…It was not part of the original description of CSD [81], but was added later [75]. Difficulty with self-motion is part of PPV [12,13], SMD [39], and CSD [75,81]. Trouble with visual motion stimuli is the primary feature of VV [15,29,63] and is emphasized in SMD [39,41,43] and CSD [75,81].…”

“…Difficulty with self-motion is part of PPV [12,13], SMD [39], and CSD [75,81]. Trouble with visual motion stimuli is the primary feature of VV [15,29,63] and is emphasized in SMD [39,41,43] and CSD [75,81]. Thus, PPV, SMD, VV, and CSD may reflect different perspectives on a single, multifaceted clinical entity or they may offer insights into potentially distinguishable subtypes of PPPD (e.g., posturally predominant subtype, visually predominant subtype).…”