REVIEWS   

Otorinolaringologia 2005 June;55(2):115-22

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Betahistine in the treatment of vertigo and Menière s disease: review of its efficacy and safety

Albera R.

Clinica ORL II, Dipartimento di Fisiopatologia Clinica Università degli Studi di Torino, Torino

Balance disturbances are one of the most common causes of medical consultation. Dizziness can arise from inner ear diseases or from other pathologies, such as neurological diseases. Dizziness therapy can be medical, surgical or rehabilitative, and the decision of the best treatment in single cases is based on the diagnosis of the disease. Medical therapy is symptomatic, pathogenetic or adjuvant vestibular compensation. Betahistine has both symptomatic and rehabilitative effect thanks to its peculiar agonist action on H1 and antagonistic action on H3 receptors, without any effect on H2 receptors. The therapeutical effects are dose-dipendent and are consequent to the inhibitory effects on the vestibular nuclei and receptors and to a vasodilatation on cerebral microcirculation. Experimental and clinical evidences suggest that the most efficacious dose is 48 mg/day. Vestibular pathologies best treated with betahistine are vestibular neuritis, recurrent acute vertigo, Menière’s disease, the support to vestibular compensation (for example after vestibular neurectomy), paroxysmal positional vertigo related to headache and vertigo associated to migraine. In conclusion, betahistine is one of the most useful drugs in the treatment of dizziness showing a very low incidence of side effects even at the dosage of 48 mg daily, actually considered the most appropriated in order to gain the best benefit from the therapy.