Betahistine in the treatment of vertigo of different etiology Review article
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Published:
Sep 30, 2017
Keywords:
betahistine, vertigo, vestibular rehabilitation
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Abstract
Betahistine, a synthetic analogue of histamine, is widely used in the treatment of Ménière’s disease and other peripheral and central vestibular vertigo – benign paroxysmal positional vertigo, vestibular neuritis, vestibular migraine, vascular vertigo and vertigo in the course of multiple sclerosis. Betahistine has also been found to be effective in support of vestibular rehabilitation.
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References
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2. Neuhauser HK, von Brevern M, Radtke A et al. Epidemiology of vestibular disorders. A neurotologic survey of the general population. Neurology 2005; 65: 898-904.
3. Neuhauser HK, Lempert T. Vertigo: epidemiologic aspects. Semin Neurol 2009; 29: 473-481.
4. Prusiński A. Klasyfikacja, obraz kliniczny i leczenie zawrotów głowy. Polski Przegląd Neurologiczny 2011; 7: 11-19.
5. Odyniec A. Betahistyna w leczeniu przedsionkowych zawrotów głowy – od mechanizmu molekularnego do efektu klinicznego. Vertigoprofil 2015; 7: 2-7.
6. Czarnecka A, Pietrzak B. Betahistyna w terapii zawrotów głowy. Terapia i Leki 2009; 65: 694-696.
7. Latkowski B. Łagodne napadowe położeniowe zawroty głowy (ŁNPZG). Latkowski B, Prusiński A (ed). Zawroty głowy (krótkie kompendium). Termedia, Poznań 2009.
8. Lee AT. Diagnosing the cause of vertigo: a practical approach. Hong Kong Med J 2012; 18: 327-332.
9. Jung I, Kim JS. Approach to dizziness in the emergency department. Clin Exp Emerg Med 2015; 2(2): 75-88.
10. Cavaliere M, Mottola G, Iemma M. Benign Paroxysmal Positional Vertigo: a study of two manoeuvres with and without betahistine. Acta Otorhinolarygol Ital 2005; 25: 107-112.
11. Guneri EA, Kustutan O. The effects of betahistine in addition to Epley maneuver in posterior canal paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2012; 146: 104-108.
12. Stambolieva K, Angov G. Effect of treatment with betahistine dihydrochloride on the postural stability in patients with different duration of benign paroxysmal positional vertigo. Int Tinnitus J 2010; 16: 32-36.
13. Itaya T, Yamamoto E, Kitano H et al. Comparison of effectiveness of maneuvers and medication in the treatment of benign paroxysmal positional vertigo. ORL J Otorhinolaryngol Relat Spec 1997; 59: 155-158.
14. Kaur J, Shamanna K. Management of Benign Paroxysmal Positional Vertigo: A Comparative Study between Epleys Manouvre and Betahistine. Int Tinnitus J 2017; 21: 30-34.
15. Brandt T, Dieterich M, Strupp M. Vertigo and dizziness – common complaints. Springer, London 2005.
16. Sekitani T, Imate Y, Noguchi T et al. Vestibular neuronitis: epidemiological survey by questionnaire in Japan. Acta Otolaryngol (Stockh) Suppl 1993; 503: 9-12.
17. Strupp M, Thurtell MJ, Shaikh AG et al. Pharmacotherapy of vestibular and ocular motor disorders including nystagmus. J Neurol 2011; 258: 1207-1222.
18. Greco A, Macri GF, Gallo A et al. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo? J Immunol Res 2014. https://doi.org/10.1155/2014/459048.
19. Strupp M, Zingler VC, Arbusov V et al. Metylprednisolone, valacyclovir, or the combination for vestibular neuritis. N Engl J Med 2004; 351: 354-361.
20. Feil K, Böttcher N, Kremmyda O. Pharmacotherapy of Vestibular Disorders, Nystagmus and Cerebellar Disorders. Fortschr Neurol Psychiatr 2015; 83: 490-498.
21. Minor LB, Schessel DA, Carey JP. Meniere’s disease. Curr Opin Neurol 2004; 17: 9-16.
22. Hornibrook J, Bird P. A new theory for Meniere’s disease. Otolaryngol Head Neck Surg 2017; 156: 350-352.
23. Strupp M, Huppert D, Frenzel C et al. Long-term prophylactic treatment of attacks of vertigo in Menière’s disease – comparison of a high with a low dosage of betahistine in an open trial. Acta Otolaryngol 2008; 128: 520-524.
24. Lezius F, Adrion C, Mansmann U et al. High-dosage betahistine dihydrochloride between 288 and 480 mg/day in patients with severe Menière’s disease: a case series. Eur Arch Otorhinolaryngol 2011; 268: 1237-1240.
25. Adrion C, Fischer CS, Wagner J et al. Efficacy and safety of betahistine treatment in patients with Meniere’s disease: primary results of a long term, multicentre, double blind, randomised, placebo controlled, dose defining trial (BEMED trial). BMJ 2016; 352: h6816.
26. W oldeamanuel YW, Cowan RP. Migraine affects 1 in 10 people worldwide featuring recent rise: a systematic review and meta-analysis of community-based studies involving 6 million participants. J Neurol Sci 2017; 372: 307-315.
27. Vukovic V, Plavec D, Galinović I et al. Prevalence of vertigo, dizziness, and migrinous vertigo in patients with migraine. Headache 2007; 47: 1427-1435.
28. Neuhauser HK, Radtke A, von Brevern M et al. Migrainous vertigo: prevalence and impact on quality of life. Neurology 2006; 67: 1028-1033.
29. Dieterich M, Oberman M, Celebisoy N. Vestibular migraine: the most frequent entity of episodic vertigo. J Neurol 2016; 263(Suppl 1): S82-S89.
30. Lauritsen CG, Marmura MJ. Current treatment options: vestibular migraine. Curr Treat Options Neurol 2017; 19: 38.
31. Amelin AV, Skoromets AA, Gonchar MA et al. Comparative efficacy of betaserc and cinnarizine of vertigo in patients with migraine. Zh Nevrol Psikhiatr im S S Korsakova 2003; 103: 43-48.
32. Karatas M. Vascular vertigo: epidemiology and clinical syndromes. Neurologist 2011; 17(1): 1-10.
33. Berkowicz T. Rozpoznanie zawrotów głowy pochodzenia naczyniowego. Vertigoprofil 2011; 4: 11-13.
34. Della Pepa C, Guidetti G, Eandi M. Betahistine in the treatment of vertiginous syndromes: a meta-analysis. Acta Otorhinolaryngol Ital 2006; 26: 208-216.
35. McDonald I, Compston A. The symptoms and signs of multiple sclerosis. Compston A (ed). McAlpine’s Multiple Sclerosis. Churchill Livingston 2005: 287-346.
36. Herrera WG. Vestibular and other balance disorders in multiple sclerosis. Neurol Clin 1990; 8: 407-420.
37. Selmaj K. Objawy kliniczne. W: Selmaj K. Stwardnienie rozsiane. Termedia, Poznań 2006: 97-98.
38. Frohman EM, Zhang H, Dewey RB et al. Vertigo in MS: utility of positional and particle repositioning maneuvers. Neurology 2000; 55: 1566-1568.
39. Popova NF, Chugunova MA, Kunel’skaia NL et al. Betahistine in the treatment of vestibular and coordination disturbances in multiple sclerosis. Zh Nevrol Psikhiatr im S S Korsakova 2011; 111: 77-81.
40. Macleod AD. Ondansetron in multiple sclerosis. J Pain Symptom Manage 2000; 20(5): 388-391.
41. Karapolat H, Celebisov N, Kirazli Y et al. Does betahistine treatment have additional benefits to vestibular rehabilitation. Eur Arch Otorhinolaryngol 2010; 267: 1207-1212.
42. Naguib MB, Madian YT. Betahistine dihydrochloride with and without early vestibular rehabilitation for the management of patients with balance disorders following head trauma: a preliminary randomized clinical trial. J Chiropr Med 2014; 13: 14-20.
43. Gekht AB, Vialkova AB, Galanov DV. Clinico-neurological and stabilometric analysis of betahistine (betaserc) efficacy in the patients with vertigo in the rehabilitation period of ischemic stroke. Zh Nevrol Psikhiatr im S S Korsakova 2005; Suppl 15: 32-38.
44. Georgescu M, Stoian S, Magoanta CA et al. Vestibulary rehabilitation – election treatment method for compensating vestibular impairment. Rom J Morphol Embryol 2012; 53: 651-656.
45. Benecke H, Pérez-Garrigues H, bin Sidek D et al. Effects of betahistine on patient-reported outcomes in routine practice in patints with vestibular vertigo and appraisal of tolerability: experience in the OSVaLD study. Int Tinnitus J 2010; 16: 14-24.
46. Parfenov VA, Golyk VA, Matsnev EI et al. Effectiveness of betahistine (48 mg/day) in patients with vestibular vertigo during routine practice: The VIRTUOSO study. PLoS One 2017; 12(3): e0174114. https://doi.org/10.1371/journal. pone.0174114. eCollection 2017.
2. Neuhauser HK, von Brevern M, Radtke A et al. Epidemiology of vestibular disorders. A neurotologic survey of the general population. Neurology 2005; 65: 898-904.
3. Neuhauser HK, Lempert T. Vertigo: epidemiologic aspects. Semin Neurol 2009; 29: 473-481.
4. Prusiński A. Klasyfikacja, obraz kliniczny i leczenie zawrotów głowy. Polski Przegląd Neurologiczny 2011; 7: 11-19.
5. Odyniec A. Betahistyna w leczeniu przedsionkowych zawrotów głowy – od mechanizmu molekularnego do efektu klinicznego. Vertigoprofil 2015; 7: 2-7.
6. Czarnecka A, Pietrzak B. Betahistyna w terapii zawrotów głowy. Terapia i Leki 2009; 65: 694-696.
7. Latkowski B. Łagodne napadowe położeniowe zawroty głowy (ŁNPZG). Latkowski B, Prusiński A (ed). Zawroty głowy (krótkie kompendium). Termedia, Poznań 2009.
8. Lee AT. Diagnosing the cause of vertigo: a practical approach. Hong Kong Med J 2012; 18: 327-332.
9. Jung I, Kim JS. Approach to dizziness in the emergency department. Clin Exp Emerg Med 2015; 2(2): 75-88.
10. Cavaliere M, Mottola G, Iemma M. Benign Paroxysmal Positional Vertigo: a study of two manoeuvres with and without betahistine. Acta Otorhinolarygol Ital 2005; 25: 107-112.
11. Guneri EA, Kustutan O. The effects of betahistine in addition to Epley maneuver in posterior canal paroxysmal positional vertigo. Otolaryngol Head Neck Surg 2012; 146: 104-108.
12. Stambolieva K, Angov G. Effect of treatment with betahistine dihydrochloride on the postural stability in patients with different duration of benign paroxysmal positional vertigo. Int Tinnitus J 2010; 16: 32-36.
13. Itaya T, Yamamoto E, Kitano H et al. Comparison of effectiveness of maneuvers and medication in the treatment of benign paroxysmal positional vertigo. ORL J Otorhinolaryngol Relat Spec 1997; 59: 155-158.
14. Kaur J, Shamanna K. Management of Benign Paroxysmal Positional Vertigo: A Comparative Study between Epleys Manouvre and Betahistine. Int Tinnitus J 2017; 21: 30-34.
15. Brandt T, Dieterich M, Strupp M. Vertigo and dizziness – common complaints. Springer, London 2005.
16. Sekitani T, Imate Y, Noguchi T et al. Vestibular neuronitis: epidemiological survey by questionnaire in Japan. Acta Otolaryngol (Stockh) Suppl 1993; 503: 9-12.
17. Strupp M, Thurtell MJ, Shaikh AG et al. Pharmacotherapy of vestibular and ocular motor disorders including nystagmus. J Neurol 2011; 258: 1207-1222.
18. Greco A, Macri GF, Gallo A et al. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo? J Immunol Res 2014. https://doi.org/10.1155/2014/459048.
19. Strupp M, Zingler VC, Arbusov V et al. Metylprednisolone, valacyclovir, or the combination for vestibular neuritis. N Engl J Med 2004; 351: 354-361.
20. Feil K, Böttcher N, Kremmyda O. Pharmacotherapy of Vestibular Disorders, Nystagmus and Cerebellar Disorders. Fortschr Neurol Psychiatr 2015; 83: 490-498.
21. Minor LB, Schessel DA, Carey JP. Meniere’s disease. Curr Opin Neurol 2004; 17: 9-16.
22. Hornibrook J, Bird P. A new theory for Meniere’s disease. Otolaryngol Head Neck Surg 2017; 156: 350-352.
23. Strupp M, Huppert D, Frenzel C et al. Long-term prophylactic treatment of attacks of vertigo in Menière’s disease – comparison of a high with a low dosage of betahistine in an open trial. Acta Otolaryngol 2008; 128: 520-524.
24. Lezius F, Adrion C, Mansmann U et al. High-dosage betahistine dihydrochloride between 288 and 480 mg/day in patients with severe Menière’s disease: a case series. Eur Arch Otorhinolaryngol 2011; 268: 1237-1240.
25. Adrion C, Fischer CS, Wagner J et al. Efficacy and safety of betahistine treatment in patients with Meniere’s disease: primary results of a long term, multicentre, double blind, randomised, placebo controlled, dose defining trial (BEMED trial). BMJ 2016; 352: h6816.
26. W oldeamanuel YW, Cowan RP. Migraine affects 1 in 10 people worldwide featuring recent rise: a systematic review and meta-analysis of community-based studies involving 6 million participants. J Neurol Sci 2017; 372: 307-315.
27. Vukovic V, Plavec D, Galinović I et al. Prevalence of vertigo, dizziness, and migrinous vertigo in patients with migraine. Headache 2007; 47: 1427-1435.
28. Neuhauser HK, Radtke A, von Brevern M et al. Migrainous vertigo: prevalence and impact on quality of life. Neurology 2006; 67: 1028-1033.
29. Dieterich M, Oberman M, Celebisoy N. Vestibular migraine: the most frequent entity of episodic vertigo. J Neurol 2016; 263(Suppl 1): S82-S89.
30. Lauritsen CG, Marmura MJ. Current treatment options: vestibular migraine. Curr Treat Options Neurol 2017; 19: 38.
31. Amelin AV, Skoromets AA, Gonchar MA et al. Comparative efficacy of betaserc and cinnarizine of vertigo in patients with migraine. Zh Nevrol Psikhiatr im S S Korsakova 2003; 103: 43-48.
32. Karatas M. Vascular vertigo: epidemiology and clinical syndromes. Neurologist 2011; 17(1): 1-10.
33. Berkowicz T. Rozpoznanie zawrotów głowy pochodzenia naczyniowego. Vertigoprofil 2011; 4: 11-13.
34. Della Pepa C, Guidetti G, Eandi M. Betahistine in the treatment of vertiginous syndromes: a meta-analysis. Acta Otorhinolaryngol Ital 2006; 26: 208-216.
35. McDonald I, Compston A. The symptoms and signs of multiple sclerosis. Compston A (ed). McAlpine’s Multiple Sclerosis. Churchill Livingston 2005: 287-346.
36. Herrera WG. Vestibular and other balance disorders in multiple sclerosis. Neurol Clin 1990; 8: 407-420.
37. Selmaj K. Objawy kliniczne. W: Selmaj K. Stwardnienie rozsiane. Termedia, Poznań 2006: 97-98.
38. Frohman EM, Zhang H, Dewey RB et al. Vertigo in MS: utility of positional and particle repositioning maneuvers. Neurology 2000; 55: 1566-1568.
39. Popova NF, Chugunova MA, Kunel’skaia NL et al. Betahistine in the treatment of vestibular and coordination disturbances in multiple sclerosis. Zh Nevrol Psikhiatr im S S Korsakova 2011; 111: 77-81.
40. Macleod AD. Ondansetron in multiple sclerosis. J Pain Symptom Manage 2000; 20(5): 388-391.
41. Karapolat H, Celebisov N, Kirazli Y et al. Does betahistine treatment have additional benefits to vestibular rehabilitation. Eur Arch Otorhinolaryngol 2010; 267: 1207-1212.
42. Naguib MB, Madian YT. Betahistine dihydrochloride with and without early vestibular rehabilitation for the management of patients with balance disorders following head trauma: a preliminary randomized clinical trial. J Chiropr Med 2014; 13: 14-20.
43. Gekht AB, Vialkova AB, Galanov DV. Clinico-neurological and stabilometric analysis of betahistine (betaserc) efficacy in the patients with vertigo in the rehabilitation period of ischemic stroke. Zh Nevrol Psikhiatr im S S Korsakova 2005; Suppl 15: 32-38.
44. Georgescu M, Stoian S, Magoanta CA et al. Vestibulary rehabilitation – election treatment method for compensating vestibular impairment. Rom J Morphol Embryol 2012; 53: 651-656.
45. Benecke H, Pérez-Garrigues H, bin Sidek D et al. Effects of betahistine on patient-reported outcomes in routine practice in patints with vestibular vertigo and appraisal of tolerability: experience in the OSVaLD study. Int Tinnitus J 2010; 16: 14-24.
46. Parfenov VA, Golyk VA, Matsnev EI et al. Effectiveness of betahistine (48 mg/day) in patients with vestibular vertigo during routine practice: The VIRTUOSO study. PLoS One 2017; 12(3): e0174114. https://doi.org/10.1371/journal. pone.0174114. eCollection 2017.