Histamine Antagonists for Treatment of Peripheral Vertigo: A Meta-Analysis

Abstract

OBJECTIVE:Vertigo, the hallucination of movement of oneself or one's surroundings, can have substantial adverse effects on the quality of life of affected patients. It is essential to decrease the frequency, severity, and duration of vertigo attacks using effective medications with minimal debilitating adverse effects. We performed a meta-analysis of available clinical trials to evaluate the efficacy of histamine antagonists in the treatment of vertigo compared to the rate of resolution in untreated control groups. MATERIALS and METHODS:A systematic search of articles in any language from January 1970 to March 2015 was performed through the following databases: the Cochrane Central Register of Controlled Trials, Medical Literature Analysis and Retrieval System Online, the Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature, Allied and Complementary Medicine Database, Web of Science, ClinicalTrials.gov, and Google. Randomized controlled trials comparing each kind of antihistamine to untreated control participants in the treatment of vertigo (blinded/unblinded) were screened for inclusion. Three reviewers separately performed data extraction from the included trials using a standard data abstraction form. Three other researchers read the final list of all articles retained. Discrepancies were settled by mutual consensus between the authors. Random effects models were applied to estimate the pooled odds ratio (OR) and 95% confidence interval (CI) using the Review Manager software. The evaluation of publication bias was performed by Egger's test and Begg's funnel plot. RESULTS:We identified 13 eligible citations. The pooled OR was 5.370, 95% CI (3.263-8.839), and I2=56.0%, with no obvious evidence of publication bias. CONCLUSION:Our results provide clarification of the effectiveness of several categories of histamine antagonists compared with placebos in controlling peripheral vertigo.

Histamine receptors and cancer pharmacology: an update

“…The H 3 receptor belongs to the GPCRs (Gα i/o ), and its activation leads to inhibition of cAMP formation, the accumulation of Ca2+ and stimulation of the MAPK pathway (Dimitriadou et al ., 1994; Shahid et al ., 2009). The HRH3 gene consists of three introns, showing significant splice variance (Shahid et al ., 2009), and H 3 receptor blocking ligands are involved in the search for the treatment of CNS disorders (Kantor and Jurkiewicz, 2006; Dauvilliers et al ., 2013; Kasteleijn‐Nolst Trenité et al ., 2013; Amini et al ., 2015; Szakacs et al ., 2017).…”

Effect of the novel histamine H4 receptor antagonist SENS‐111 on spontaneous nystagmus in a rat model of acute unilateral vestibular loss

“…Histamine receptor antagonists block histaminergic activation and have been used to demonstrate a role for members of this receptor family, specifically http://www.guidetopharmacology.org/GRAC/ObjectDisplayForward?objectId=262&familyId=33&familyType=GPCR 1 and http://www.guidetopharmacology.org/GRAC/ObjectDisplayForward?objectId=263&familyId=33&familyType=GPCR 2 receptors, in modulating vestibular function (Housley, Norris, & Guth, 1988). Several H 1 and http://www.guidetopharmacology.org/GRAC/ObjectDisplayForward?objectId=264&familyId=33&familyType=GPCR 3 receptor antagonists have been evaluated and are used as part of pharmacotherapy for vestibular dysfunction such as AUV, or motion sickness, notably meclizine (Cohen & DeJong, 1972) and more recently betahistine (Amini et al, 2015). However, the use of many of these agents is limited by the associated sedation, which reduces or delays central compensation, a process essential to effective long‐term recovery.…”

Inhibition of gap junctional intercellular communication by an anti-migraine agent, flunarizine

“…FNZ is a versatile drug used for various pathological conditions because of its various pharmacological activities; it not only blocks calcium entry [19], but also inhibits the function of dopamine D 2 [20], histamine H 1 [21], and 5-HT receptors [22]. FNZ is useful in preventing migraine attacks and is also used as an add-on treatment in drug-resistant epilepsy patients, occlusive peripheral vascular disease, and central and peripheral vertigo [19].…”