Perspectives on the Pharmacotherapy of Vertigo

Zee, David S.

doi:10.1001/archotol.1985.00800110087009

Cited by 62 publications

(16 citation statements)

References 29 publications

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“…One untested hypothesis is that the agents may cause an acute, bilateral reduction in vestibular responsiveness or may destabilize occult vestibular compensation through an effect on cerebellar function. It is possible that the agent may act as a stimulus to produce long-term central vestibulosuppression (22). Against this theory is the observation that people with central vestibular disorders do not respond well to Innovar (see below).…”

Section: Discussionmentioning

confidence: 99%

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Innovar Treatment for Meniere's Disease

Gates

1999

Acta Oto-Laryngologica

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Patients with intractable vertigo due to clinical Meniere's disease were offered treatment with Innovar, a neurolept analgesic. The patients were from a single clinical practice, had failed conventional dietary and medical treatment and were eligible on clinical grounds for endolymphatic sac surgery. After a follow-up of 2-8 years, 58% of patients had long-lasting relief of vertigo. Hearing was not affected. Risk factors for a favorable response were male gender, fluctuating hearing, and early stage of the disorder. Innovar is a safe, cost-effective second-line therapy for patients with Meniere's disease who have failed conventional first-line medical therapy.

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Section: Discussionmentioning

confidence: 99%

“…Long-term diazepam use is discouraged because of its potential for addiction, impaired memory, sedation and falling. Concern also exists about the risk for an adverse effect on vestibular compensation (13).…”

Section: Introductionmentioning

confidence: 99%

Innovar Treatment for Meniere's Disease

Gates

1999

Acta Oto-Laryngologica

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“…Meclizine, one of the most commonly used vestibular suppressants, can limit the brain's ability to compensate for centrally mediated vestibular disorders through its vestibular suppression; therefore, its role in postconcussion-related dizziness may be quite limited. Though pharmacologic agents that act as vestibular suppressants have been shown to be effective in the acute treatment of vestibular disorders [38], these medications have not been studied following concussion and their efficacy is questionable.…”

Section: Vestibular Impairmentsmentioning

confidence: 99%

Treating Prolonged Symptoms of Mild Traumatic Brain Injury: Neuropharmacology

Lercher

Reddy²

2014

Progress in Neurological Surgery

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The clinical presentation of concussion can vary widely as patients experience any number of symptoms including headache, dizziness, cognitive symptoms of difficulty with concentration and memory, sleep dysregulation, and mood disturbances. The variability in clinical presentation underscores the importance of thorough history-taking to clearly understand the clinical picture and to allow individualization of the treatment plan. Most postconcussive symptoms are transient in nature and respond to conservative measures, including education of the patient and their caregivers. For those individuals whose symptoms persist or significantly impair quality of life, pharmacologic intervention may be warranted. Though few studies have investigated the use of pharmacology for treatment of postconcussion syndrome specifically, targeted treatment of medications known to improve selected symptoms can be considered.

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“…Medications such as stimulants, benzodiazepines, tricyclics, monoamine oxidase inhibitors, tetracyclics, neuroleptics, selective serotonin reuptake inhibitors, beta blockers, and cholinesterase inhibitors may cause or exacerbate dizziness. Vestibular suppression may be useful in the acute phase but has not proven effective for persistent symptoms 89. Vestibular suppressants should only be used if the symptoms significantly limit the patient's functional activities as they may result in delayed improvement 90-91.…”

Section: Treatment Of Mtbimentioning

confidence: 99%

Traumatic Alterations in Consciousness: Traumatic Brain Injury

Blyth

Bazarian

2010

Emergency Medicine Clinics of North America

116

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Mild traumatic brain injury (mTBI) refers to the clinical condition of transient alteration of consciousness as a result of traumatic injury to the brain. The priority of emergency care is to identify and facilitate the treatment of rare but potentially life threatening intra-cranial injuries associated with mTBI through the judicious application of appropriate imaging studies and neurosurgical consultation. Although post-mTBI symptoms quickly and completely resolve in the vast majority of cases, a significant number of patients will complain of lasting problems that may cause significant disability. Simple and early interventions such as patient education and appropriate referral can reduce the likelihood of chronic symptoms. Although definitive evidence is lacking, mTBI is likely to be related to significant long-term sequelae such as Alzheimer's disease and other neurodegenerative processes.

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Perspectives on the Pharmacotherapy of Vertigo

Cited by 62 publications

References 29 publications

Innovar Treatment for Meniere's Disease

Innovar Treatment for Meniere's Disease

Treating Prolonged Symptoms of Mild Traumatic Brain Injury: Neuropharmacology

Traumatic Alterations in Consciousness: Traumatic Brain Injury

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