Pharmacotherapy of vertigo: modern data of evidence-based medicine

December 28, 2022
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Vertigo accompanies the course of various diseases; common forms of peripheral vertigo are benign paroxysmal positional vertigo and Meniere’s disease. The course of benign paroxysmal positional vertigo is characterized by attacks of systemic dizziness, the appearance of nystagmus, and the development of autonomic reactions in the form of nausea and vomiting. Meniere’s disease is characterized by vertigo with simultaneous hearing impairment, tinnitus. Symptomatic drug therapy of vertigo is based on the appointment of antihistamines, benzodiazepines, calcium channel antagonists, diuretics, corticosteroids, and antipsychotics. The impracticali­ty of using betahistine in the treatment of vertigo has been demonstrated. The properties of cinnarizine and dimenhydrinate are described: cinnarizine normalizes the state of the peripheral vestibular analyzer, blocks potential-dependent calcium channels, counteracts the narrowing of cerebral vessels and reduces the viscosity of blood in the circulatory system of the inner ear; dimenhydrinate enhances the effect of cinnarizine and provides additional anticholinergic and antiemetic effects. It was established that the use of a fixed combination of cinnarizine/dimenhydrinate contributes to the complete elimination of vertigo in 24.7%, and the almost residual disappearance of vertigo in 69.9% of patients. The efficacy and safety of a fixed combination of cinnarizine/dimenhydrinate in the treatment of central and peripheral vertigo has been proven.

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