OBJECTIVE: To evaluate the efficacy and safety of Venlafaxine for the control of vestibular migraine (VM). METHODS: This is a systematic review of randomized clinical trials. The following databases were searched: PUBMED (1966-2021), EMBASE (1974-2021) and CENTRAL (Cochrane Library-2021). There was no geographic and period limitation in the survey. Data extraction and study quality assessment were carried out by two independent researchers. RESULTS: The search strategy identified 47 studies, of which 2 were included in this review, as they met the inclusion and exclusion criteria. Both evaluated the efficacy of venlafaxine in vestibular migraine, comparing the results with other drugs. The first study (2017) compared the effect of venlafaxine with flunarizine and valproic acid, while the second study (2015) compared the efficacy of venlafaxine with propranolol. Both showed improvement of vestibular symptoms in all groups evaluated, but only the groups submitted to treatment with venlafaxine showed a significant change in the emotional DHI (Dizziness Handicap Inventory) score and improvement in depressive symptoms. CONCLUSIONS: Although venlafaxine appears to have promising results, there is currently a scarcity of studies that allow currently to assess the efficacy and safety of the drug for the treatment of vestibular migraine. The evidence is quite limited, the number of studies and patients evaluated reduced, and it is recommended to conduct new quality randomized clinical trials to elucidate the issue.

OBJECTIVES: Vestibular migraine is the leading cause of episodic vertigo and the second most common cause of dizziness in adults, due to its high prevalence, negative impacts on individual health, and increased public health expenditures, preventive treatment should be implemented early. This paper aimed to evaluate the efficacy of Flunarizine as a preventive for vestibular migraine crises in comparison to other drugs.   METHODS: We searched the databases for scientific articles using the terms (vestibular migraine OR migrainous vertigo) AND (Flunarizine) AND (prophylaxis). Subsequently, a systematic literature review and meta-analysis was performed, with the inclusion of 3 randomized clinical trials. The studies were analysed by making a ROB table, analysis using the GRADE method, and meta-analysis. RESULTS: Qualitatively, the analysis showed that Flunariniza was positive for decreasing the frequency of vertigo in cases of vestibular migraine, with moderate degree of evidence, relative risk of 0.34 and confidence interval 0.15 to 0.76. The meta-analysis showed a positive result of Flunarizine as a preventive drug for the study population. No serious side effects were reported from the use of the medication, which makes it safe for use by patients. CONCLUSION: Flunarizine is a good drug for prevention of vestibular migraine.