Postmarketing study of the use of flunarizine in vestibular vertigo and in migraine

Verspeelt, J.; Locht, P. De; Amery, Willem K.

doi:10.1007/s002280050154

Cited by 29 publications

(11 citation statements)

References 2 publications

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“…In conclusion, the outcomes of this study are in agreement with the effective and safe profile of betahistine, as reported in other short-term or long-term trials, carried out with a similar methodology [10,11,12,13,14,15,16] and the statement on its efficacy in treating different forms of vertigo of peripheral vestibular origin, either as Meniere's disease or paroxysmal positional vertigo. According to the methodological suggestions of Schmidt and Huizing [2], Meniere's disease patients who had participated in the trial did not stop their medication at the end of the study.…”

Section: Discussionsupporting

confidence: 89%

“…The outcome of this study, which was double-blinded and placebo-controlled with parallel groups, confirms the efficacy of betahistine in the treatment of paroxysmal vertigo and Meniere's disease; this has already been observed both in crossover and parallel-group studies [10,11,12,13,14,15,16].…”

Section: Discussionsupporting

confidence: 77%

“…The therapeutic effect of betahistine, as well its safety, has been shown in many controlled clinical studies in vertigo patients [10,11,12,13,14,15,16].…”

Section: Introductionmentioning

confidence: 99%

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Betahistine dihydrochloride in the treatment of peripheral vestibular vertigo

Mira

Guidetti

Ghilardi

et al. 2003

Eur Arch Otorhinolaryngol

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The present study compares the efficacy and safety of betahistine dihydrochloride to that of a placebo in recurrent vertigo resulting from Meniere's disease (MD) or in paroxysmal positional vertigo (PPV) of probable vascular origin. The design was double-blind, multicentre and parallel-group randomised. Eleven Italian cen-tres enrolled 144 patients: 75 of the patients were treated with betahistine (41 MD/34 PPV) and 69 with placebos (40 MD/29 PPV). The betahistine dosage was 16 mg twice per day for 3 months. Compared to the placebo, betahistine had a significant effect on the frequency, intensity and duration of vertigo attacks. Associated symptoms and the quality of life also were significantly improved by betahistine. Both the physician's judgement and the patient's opinion on the efficacy and acceptability of the treatment were in agreement as to the superiority of betahistine. The effective and safe profile of betahistine in the treatment of vertigo due to peripheral vestibular disorders was confirmed.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 77%

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Betahistine dihydrochloride in the treatment of peripheral vestibular vertigo

Mira

Guidetti

Ghilardi

et al. 2003

Eur Arch Otorhinolaryngol

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“…33 They also have anticholinergic, antihistaminergic and antidopaminergic actions. 34 Another calcium channel blocker nimodipine was shown to be effective in Meniere's disease. 35 Anticonvulsants: Gabapentin, carbamazepine and oxcarbazepine are used in the treatment of vertigo although not studied extensively.…”

Section: Pharmacotherapy Of Vertigomentioning

confidence: 99%

Current Perspectives in the Pharmacotherapy of Vertigo

Singh¹,

Singh²

2012

An International Journal of Otorhinolaryngology Clinics

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Vertigo is a symptom encountered very commonly in clinical practice due to a disorder in the vestibular system. In addition to dizziness it is very often accompanied by nausea and vomiting. Pharmacotherapy plays an important role in the management of vertigo. Vestibular suppressants and drugs to control nausea and vomiting constitute the mainstay of the pharmacotherapy of vertigo. Specific drug therapy can be given in patients where the underlying disease process causing the vertigo has been identified. Despite the availability of many classes of drugs, there are no definitive, universally accepted guidelines for the treatment of vertigo which makes it even more difficult to follow first-, second-and third-line therapies when treating patients. It is difficult to establish guidelines or a generally acceptable consensus in the treatment of vertigo due to the complexity of vertigo and lack of adequate randomized clinical studies.

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“…In two large open-label post-marketing studies, flunarizine was reported to be effective for migraine (compared to propranolol) and vertigo (compared with betahistine). 38,39 The results from these big cohorts cannot be directly related to the response to VM, since both studies evaluated the two symptoms independantly of each other. A fourth analysis of this agent evaluated the efficacy of flunarizine and propranolol in VM and found both drugs to be comparably effective.…”

Section: Prophylactic Treatmentmentioning

confidence: 99%

Treatment Options for Vestibular Migraine

Naegel¹,

Matharu²,

Obermann³

2016

US Neurology

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39Population based studies show that primary headaches, such as migraine, are very common disorders. 1 Similar accounts to vertigo and dizziness, which are are also symptoms frequently complained of. 2 A significant proportion of patients report suffering these symptoms (headache, dizziness and/or vertigo) simultaneously and independently of each other. This especially accounts for migraine since up to 50% of these patients report that dizziness or vertigo accompanies their headaches at least once in a while. 3,4 After a first attempt to introduce the term "vestibular migraine" (VM) was made in 1999 5 the International Headache Society (IHS) and the Bárány-Society (International Society for Neuro-Otology) just recently published a consensus paper with diagnostic criteria for VM. 6,7 These criteria were adopted as appendix criteria in the beta version of the third International Classification of Headache Disorders (ICHD-3 beta) to support systematic research on the pathophysiology and treatment of VM. 8 In the clinical setting, these new criteria may serve to aid practitioners in the assessment of patients with VM. While vertigo specialists generally accept the existence of this entity, between headache specialists the discussion is much more controversial. Some people favour this entity, others doubt the existence of the disorder. There is an ongoing debate whether the condition is a unique entity or it simply represents a subtype of common migraine, which also includes vestibular symptoms given that migraines often occurs with predominance of other accompanying symptoms such as excessive vomiting or phonophobia. In contrast there is wide agreement that the pathophysiology of the disorder/symptom complex remains uncertain. 9Recent studies report that approximately two-thirds of patients experiencing vertigo or dizziness seek medical care because of their symptoms, but VM was diagnosed in only 20% of all patients. 10 Interestingly, in routine clinical practice, clinicians reach multiple different interpretations of the symptom complex of headache and vertigo, and these interpretations are often speciality dependent. Neurologists were reported to diagnose VM in 82% of patients with this constellation, while only 64.5% of Ear, Nose, and Throat physicians made this diagnosis. 10 Specific trials particularly addressing the treatment of VM are rare and most treatment guidelines are extrapolated from clinical trials on migraine with and without aura. This review summarizes the available data regarding specific treatment of VM. AbstractAlthough vestibular migraine is a common cause of vertigo, affecting approximately 1% of the Western world's population, it remains widely under-recognized and is under-diagnosed. Diagnostic criteria for vestibular migraine were recently published in collaboration with the International Headache Society and the Bárány-Society. Trials investigating the treatment of vestibular migraine are sparse but some are now underway. This review focuses on the treatments options available for vestibula...

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Postmarketing study of the use of flunarizine in vestibular vertigo and in migraine

Cited by 29 publications

References 2 publications

Betahistine dihydrochloride in the treatment of peripheral vestibular vertigo

Betahistine dihydrochloride in the treatment of peripheral vestibular vertigo

Current Perspectives in the Pharmacotherapy of Vertigo

Treatment Options for Vestibular Migraine

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