Betahistine hydrochloride in Méniére's disease

Frew, Ivor; Menon, Gopi

doi:10.1136/pgmj.52.610.501

Cited by 44 publications

(40 citation statements)

References 6 publications

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“…Betahistine dihydrochloride is a drug commonly used in treating vertigo, particularly in Meniere's disease, and decreases frequency of the attacks [16,17] . There have been various opinions on the mechanism of effect of betahistine in the literature [9,[18][19][20] , however, the mechanism is not clear yet.…”

Section: Groupmentioning

confidence: 99%

The Effects of Betahistine and Dimenhydrinate on Caloric Test Parameters; Slow-Phase Velocity of Nystagmus

Kıroğlu¹,

Dagkiran²,

Özdemir³

et al. 2014

Int Adv Otol

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OBJECTIVE:The aim of this study is to determine the effects of betahistine and dimenhydrinate on the slow phase velocity. MATERIALS and METHODS:Forty patients with complaints of vertigo and dizziness volunteered to be included in the study. All patients who were included the study were treated at the other medical centers. The patients were divided into two Groups. Patients in the first Group were given betahistine 24 mg three times per day. During this treatment, caloric testing was performed, and the dose was increased to 48 mg three times a day due to ongoing complaints. The test was then repeated four weeks after using this higher dosage. Patients in the second Group had caloric testing while using and four weeks after stopping dimenhydrinate. RESULTS:The study Group was comprised of 40 patients; 20 patients (13 female, 7 male, 18-68 years, median age 46) in the betahistine Group and 20 patients (14 female, 6 male, 24-74 years, median age 44.5) in the dimenhydrinate Group. The average slow phase maximum velocity in the first Group of patients was 18 -/+ 8.2 and 21.1 -/+ 10.8 deg/s at 24 mg betahistine three times a day and 48 mg three times a day, respectively. In the second Group of patients, the average slow phase velocity was 13.4 -/+ 5.1 and 18.2 -/+ 7.5 deg/s during and after stopping the treatment of dimenhydrinate, respectively. The caloric test-induced slow-phase velocity was decreased with dimenhydrinate and increased with the higher dosage of betahistine. CONCLUSION:To our knowledge, this is the first study to demonstrate that betahistine increases caloric-induced slow-phase velocity in humans. Dimenhydrinate and betahistine should not be used together because of their opposite effects on the vestibular system. Dimenhydrinate can be used to treat acute episodes of vertigo, whereas betahistine should not be used during the episode but may be used in the period between the attacks to stimulate the vestibular system.

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Section: Groupmentioning

confidence: 99%

The Effects of Betahistine and Dimenhydrinate on Caloric Test Parameters; Slow-Phase Velocity of Nystagmus

Kıroğlu¹,

Dagkiran²,

Özdemir³

et al. 2014

Int Adv Otol

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“…

P eripheral vestibular loss induces a syndrome involving different levels of deficits, ranging from postural and oculomotor reflexes to spatial cognition. Patients were examined before (day -1) and after UVN (days 7,30, and 90). 1-4 Static symptoms, observed in motionless patients, peak in intensity within a few days following vestibular loss.

…”

mentioning

confidence: 99%

Betahistine Treatment Improves the Recovery of Static Symptoms in Patients With Unilateral Vestibular Loss

Redon

Lopez

Bernard-Demanze

et al. 2011

The Journal of Clinical Pharmacology

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Vestibular loss induces a combination of postural, oculomotor, and perceptive symptoms that are compensated over time. The aim of this study was to analyze the influence of betahistine dihydrochloride on vestibular compensation. A randomized, double-blind, placebo-controlled study was performed in Menière's disease patients who underwent a curative unilateral vestibular neurotomy (UVN). The effects of betahistine treatment were investigated on a broad spectrum of vestibular-induced changes resulting from vestibular loss: body sway, head orientation, ocular cyclotorsion, spontaneous nystagmus, verticality perception, and self-evaluation of the postural stability. The time course of the recovery was compared in 16 patients who received either a placebo or betahistine (24 mg b.i.d.) from 3 days up to 3 months after UVN. Patients were examined before (day -1) and after UVN (days 7, 30, and 90). Results indicate that betahistine reduces the time to recovery by 1 month or more depending on the tested functions. Betahistine was effective as soon as 4 days after treatment administration, and the effect remained during the whole compensation period (up to 3 months). The observed clinical effects may be attributed to an action of betahistine in rebalancing the neuronal activity between contralateral vestibular nuclei.

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“…Most of them have been focused on subjective scales with vertigo as the main symptom [46], and/or on questionnaires on self-evaluation of quality of life [1,23,[55][56][57]. Indeed, the unpredictable and sudden attacks of vertigo are the main disabling problem in MD, impairing quality of life and leading to secondary psychiatric problems (anxiety, fear, depression, .…”

Section: Clinical Data In Vestibular Loss Patientsmentioning

confidence: 99%

Betahistine treatment in managing vertigo and improving vestibular compensation: Clarification

Lacour

2013

VES

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Betahistine dihydrochloride (betahistine) is currently used in the management of vertigo and vestibular pathologies with different aetiologies. The main goal of this review is to clarify the mechanisms of action of this drug, responsible for the symptomatic relief of vertigo and the improvement of vestibular compensation. The review starts with a brief summary recalling the role of histamine as a neuromodulator/neurotransmitter in the control of the vestibular functions, and the role of the histaminergic system in vestibular compensation. Then are presented data recorded in animal models demonstrating that betahistine efficacy can be explained by mechanisms targeting the histamine receptors (HRs) at three different levels: the vascular tree, with an increase of cochlear and vestibular blood flow involving the H1R; the central nervous system, with an increase of histamine turnover implicating the H3R, and the peripheral labyrinth, with a decrease of vestibular input implying the H3R/H4R. Clinical data from vestibular loss patients show the impact of betahistine treatment for the long-term control of vertigo, improvement of balance and quality of life that can be explained by these mechanisms of action. However, two conditions, at least, are required for reaching the betahistine therapeutic effect: the dose and the duration of treatment. Experimental and clinical data supporting these requirements are exposed in the last part of this review.

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Betahistine hydrochloride in Méniére's disease

Cited by 44 publications

References 6 publications

The Effects of Betahistine and Dimenhydrinate on Caloric Test Parameters; Slow-Phase Velocity of Nystagmus

The Effects of Betahistine and Dimenhydrinate on Caloric Test Parameters; Slow-Phase Velocity of Nystagmus

Betahistine Treatment Improves the Recovery of Static Symptoms in Patients With Unilateral Vestibular Loss

Betahistine treatment in managing vertigo and improving vestibular compensation: Clarification

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