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NJIRM. 2013; 4(4): 118-128

Anti vertigo Drugs-Revisited

Ajeet Kumar Khilnani*, Rekha Thaddanee**, Gurudas Khilnani***.

Vertigo is a sense of whirling and rotation and is frequently associated with nausea and vomiting. Vertigo is a cardinal manifestation of vestibular disorders. Pharmacotherapy is required for symptomatic treatment of vertigo and motion sickness irrespective of the aetiology. Drugs like cinnarizine, betahistine and scopolamine are time honoured drugs. Antihistaminics and phenothiazines are also useful agents. Surprisingly, very few newer agents have shown undisputed efficacy against vertigo. This review describes the neurotransmitters involved in the genesis of vertigo and current status and evolution of appropriate pharmacological options for the treatment. [Khilnani AK et al NJIRM 2013; 4(4) : 118-128]

Key words: Anticholinergic drugs for vertigo, Antihistaminics as antivertigo drugs, Pharmacotherapy of vertigo

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1. Linas R, Walton K, Hillman DE, Sotelo C. Inferior
Olive: Its role in motor learning. Science
2. Goldberg JM,Brichta AM, Wackym PA. Efferent
vestibular system: Anatomy, physiology and
neurochemistry. In: Beitz JA, Andersen JH (eds).
Neurochemistry of the vestibular system.
London: CRC Press, 2000: 61-94.
3. Takeda N, Mashahiro M, Hasegawa S, Kubo T,
Matsunaga T. Neurochemical mechanisms of
motion sickness. Am J Otolaryngol 10: 351-359,
4. Vibert N, Serafin M, De Waele C, Babalian A,
Muhlethaler M, Vidal PP. Modulatory effects of
monoamines on central vestibular neurons:
possible functional implications. In: Beitz JA,
Andersen JH (eds). Neurochemistry of the
vestibular system. London: CRC Press, 2000:
NJIRM 2013; Vol. 4(4).July - August
5. Pedigo NW Jr, Brizzee KR. Muscarinic
cholinergic receptors in area postrema and
brain stem areas regulating emesis. Brain Res
Bull 1985;14:169-77
6. Nerveen JV, Pompeiano O, Collewign H.
Depression of the vestibule-ocular reflex and
microinjection of GABA-A and GABA-B agonists
in rabbit. Arch Ital Biol 1989; 127:243-63.
7. Cohen B, de jong J. Meclizine and placebo in
treating vertigo of vestibular origin. Relative
efficacy a double blind study. Arch Neurol 1972;
8. Johnston AR, Him A, Dutia MB. CA. Differential
regulation of GABA-A and GABA-B receptors
during vestibular compensation. Neuroreport.
2001; 12:597-600.
9. Sasa M, takeshita S, Amano T, Kurishu K.
Primary neurotransmitters
and regulatory
substances onto vestibular nucleus neurons.
Biol Sci Space. 2001 Dec;15(4):371-4.
10. Cheung BS, Money KE, Kohl RL, Kinter LB.
Investigation of
antimotion sickness
drugs in the squirrel monkey. J Clin Pharmacol
1992; 32:163-75.)
11. Norfleet WT, Degioanni JJ, calkins DS.
Treatment of motion sickness in parabolic flight
with buccal scopolamine. Aviat Space Environ
Med 1992; 63:46-51
12. Klocker N, Hanschke W, Toussaint S, Verse T.
Scopolamine nasal spray in motion sickness: a
randomised, controlled, and crossover study for
the comparison of two scopolamine nasal
sprays with oral dimenhydrinate and placebo.
European journal of Pharmaceutical sciences.
2001; 13:227-32.
13. Parrott AC. Transdermal scolpolamine: A
review of its effects upon motion sickness,
psychological performance and physiological
functioning. Aviat Space Envirn Med 1989;
14. Pingree BJ, Pethybridge RJ. A comparison of
the efficacy of cinnarizine with scopolamine in
the treatment of seasickness. Aviation space
and environmental medicine. 1994; 65:597-605.
15. Gordon CR, Gonen A, Nachum Z, Doweck I,
Spitzer O, Shupak A. The effects of
dimenhydrinate, cinnarizine and transdermal
scopolamine on performance. Journal of
Psychopharmacology. 2001; 15:167-72.
16. Osterholm RK, Camoriano JK. Transdermal
scoplomanie psychosis. JAMA 1982;247:3081
17. Luetje CM, Wooten J. Clinical manifestations of
transdermal scopolamine addiction. Ear Nose
Throat J 1996; 75:210-14.
18. Gordon CR, Shupak A, Doweck I, spitzer O.
Allergic contact dermatitis. Caused by
transdermal hyosine BMJ 1989; 298:1220-21.
19. JF Golding, JR Stott. Comparison of the effects
of a selective muscarinic receptor antagonist
and hyoscine (scopolamine) on motion sickness,
skin conductance and heart rate. Bri J Clin
Pharmacol 1997 Jun; 43 (6): 633-7.
20. Timmerman H. Pharmacotherapy of Vertigo:
Any news to be expected? Acta Otolaryngol
(Stockh) 1994; 513(Suppl):28-32
21. Jackson RT, Turner JS Jr. Astamizole:its use in
the treatment of patients with chronic vertigo.
Arch otolaryngol Head Neck surg 1987;
22. Lackner JR, Graybiel A. use of promethazine to
hasten adaptation to provocative motion. J clin
Pharmacol 1994; 34:644-48.
23. Wood CD, Cramer DB, Graybiel A. Antimotion
sickness drug efficacy. Otolaryngol Head Neck
Surg 1981; 89:1041-44.
24. Muth Er, Jokerst M, Stern RM, Koch KL. Effects
of dimenhydrinate on gastric tacharrhythmia
and symptoms of vection induced motion
sickness. Aviat Space envirn Med 1995;
25. Wood CD, Graybiel A. Evaluation of sixteen
antimotion sickness drugs under controlled
laboratory conditions. Aerospace Med 1968;
26. Weinstein SE, Stern RM. Comparison of
Marezine and Dramamine in preventing
symptoms of motion sickness. Aviation space
and environmental medicine. 1997; 68: 890-4.
27. Tighilet B, Leonard J, Lacour M. Betahistine
dihydrochloride treatment facilitates vestibular
compensation in the cat. Journal of vestibular
research. 1995; 5:53-66.
28. Mira E, Guidetti G, Ghikardi PL, Fattori B,
Malnnino N, Maiolono L et al. Betahistine
dihydrochloride in the treatment of peripheral
NJIRM 2013; Vol. 4(4).July - August
vestibular vertigo. European archives of Oto-
Rhino-Laryngology. 2003; 260:73-7.
29. Halmagyi GM. Vertigo and vestibular disorders.
In Eadie JM. Eds Drug Therapy in
Neurology,Churchill Livingstone, Edinburgh,
1992, p383.
30. Kingma H, Bonink M, Meulenbroeks A. Dose
dependent effect of Betahistine on the
vestibulo-ocular reflex:a double blind placebo
controlled study in patients with paroxysmal
vertigo. Acta Otolaryngologica 1997;117(5):641-
31. Smith WK, Sankar V, Pfleiderer AG. A national
survey amongst UK otolaryngologists regarding
the treatment of Meniere's disease. Laryngol
Otol 2005; 119:102-105.
32. Della Pepa C, Guidetti G, Eandi M. Betahistine
in the treatment of vertiginous syndromes: a
meta-analysis. Acta otorhinolaryngol Ital 2006
Aug; 26: 208-15.
33. Johnson WH, Fenton RS, Evans A. Effects of
droperidol in the management of vestibular
disorders. Laryngoscope 1976; 86:946-54.
34. Miller JD, Brizzee KR. The antiemetic ptoperties
of l-sulpiride in a ground based model of space
motion sickness. Life Scienc 1987;41:1815-22.
35. Irving C, Richman PB, Kalafas C. Droperidol for
the treatment of acute peripheral vertigo. Am J
Emerg Med 1999;17:109-110.
36. Wood CD, Cramer DB, Graybiel A. Antimotion
sickness drug efficacy. Otolaryngol Head Neck
Surg 1981;89:1041-44.
37. Lee JA, Watson LA, Boothby G. calcium
antagonists in the prevention of motion
sickness. Aviat Space Envirn Med 1990;61:1022-
38. Pianese CP, Hidalgo LO, Gonzalez RH, Madrid
CE, Ponce JE, Ramirez AM et al. New
approaches to the management of peripheral
vertigo: Efficacy and safety of two calcium
antagonists in a 12 week, multinational, double
blind study. Otology and Neurotology. 2002; 23:
39. Shupak A, Doweck I, Gordon CR, Spitzer O.
Cinnarizine in the prophylaxis of sea sickness.
Clin Pharmacol Therap 1994; 55:670-80.
40. Casucci G, Costanzo A, Riva R et al. Central
actions of Cinnarizine and Flunarizine. A
Neuropharmacol 1994;17:417-22
41. Schmidt R, Oestreich W. Flunarizine in the
treatment of vestibular vertigo. Experimental
and clinical data. J cardiovasc Pharmacol
1991;18 (Suppl 8 ):S 27-30
42. Lassen LF, Hiesh BE, Kamerer DB. Use of
nimodipine in the medical treatment of
Miniere's disease. Clinical Experience. Am J Otol
43. Stern RM, Uijtdehaage SH, Muth ER, Koch Kl.
Effects of Phenytoin on vection induced motion
sickness and gastric myoelectric activity. Aviat
Space Environ Med 1994; 65:518-21
44. Stahl JS, Rottach KG, Averbuch-Heller L,
Maydell RD et al. A pilot study of gabapentin as
treatment for acquired nystagmus. Neuro-
Ophthalmology 1996;16:107-113
45. Sekitani T, McCabe BF, Ryu JH. Drug effects on
the medial vestibular nucleus. Arch Otolaryngol
1971; 93:581-89.
46. McClure JA, Lycett P, Baskerville JC. Diazepam
as an antimotion sickness drug. J Otolaryngol
47. Marill KA, Walsh MJ. Nelson BK. Intravenous
treatment of vertigo in the emergency
department A randomized clinical trial. Ann
Emerg Med 2000;36:310-19
48. Kohl RL, calkins DS. Mandell AJ. Arousal and
sympathomimetic drugs suggest a new principle
for the prevention of space motion sickness.
Aviat Space Envirn Med 1986; 57:137-43.
49. Kohl RH, Sandoz GR, raschke MF et al.
Facilitation of adaptation and acute tolerance
to stressful sensory input by doxepin and
scolpolamine plus amphetamine. J Clin
Pharmacol 1993;33:1092-1103
50. Dagilas A; Kimiskidis V; Aggelopoulou M;
Kapaki E; Fitili C; Libitaki G; Papagiannopoulos S;
Kazis D; Kazis A; Aidonis A. Changes in blood
neurotransmitter and Steroid levels during
evoked vertigo. Otology and Neurotology: May
2005- Volume 26- Issue 3 pp 476-480.
51. Parnes LS, Sun Ah, Freeman DJ. Corticosteroids
pharmacokinetics in the inner ear fluids: an
NJIRM 2013; Vol. 4(4).July - August
animal study followed by clinical application.
Laryngoscope. 1999; 109: 1-17.
52. Shea Jr JJ. The role of dexamethasone or
streptomycin perfusion tn the treatment of
Meniere's disease. Otolaryngologic Clinics of
North America. 1997; 30: 1051-9.
53. Morales-Luckie E, Cornejo-Saurez A, Zaragoza-
Contreras MA, Gonzalez-Perez O. Oral
administration of prednisone to control
refractory vertigo in Ménière's disease: a pilot
study. Otol Neurotol 2005 Sept;26(5):1022-6.
54. Ariyasu L, Byl FM, Sprague MS, Adour KK. The
beneficial effect of methylprednisolone
in acute vestibular vertigo. Arch
Head Neck Surg.1990 Jun;116(6):700-3.
55. Toshiaki Yamanaka, Masashi Sasa, Taku
Amano, Hiroshi Miyahara and Takashi
Matsunaga. Role of glucocorticoid in vestibular
compensation in relation to activation of
Vestibular Nucleus Neurons. Acta Oto-
laryngologica 1995, Volume 115, No. s519,
Pages 168-72.
56. Seemungal, Barry M.; Gresty, Michael A.;
Bronstein, Adolfo M. The endocrine system,
vertigo and balance. Current opinion in
neurology; February 2001- Volume 14- Issue 1-
PP 27-34.
57. Satyanarayana R. Pondugula, Joel D.
Sanneman, Philine Wangemann, Pierre G.
Milhaud and Daniel C. Marcus. AJP- Renal
Physiol June 1, 2004 vol. 286 no. 6F1127-F1135.
58. Van Deelen GW, Huizing EH. Use of a diuretic
(dyazide) in the treatment of Meniere's disease.
A double-blind cross-over placebo- controlled
study. ORL; Journal of Otolaryngology and its
related Specialities. 1986; 48: 287-92.
59. Salley Jr LH, Grimm M, Sismanis A, Spencer RF,
Wise CM. Methotrexate in the management of
immune mediated cochleovestibular disorders:
clinical experience with 53 patients. Journal of
Rheumatology. 2001; 28:1037-40.
60. Rascol O, Hain TC, Brefel C, Benazet M, Clanet
M, Montastruc J. Antivertigo medication and
drug induced vertigo-A pharmacological review.
DRUGS 1995; 50 :777-791.
61. Kluysken P, Lambert P, D'Hooge D.
Trimetazidine versus betahistine in vestibular
vertigo: A double blind study. Ann Otolaryngol
Chir cervicofac 1990; 107 (Suppl-1): 20-
62. Drew S, Davies E. Effectiveness of Ginkgo
biloba in treating tinnitis. Double blind placebo
controlled trial. BMJ 2001; 322:73.
63. Hain TC. Alternative treatments for Miniere's
NJIRM 2013; Vol. 4(4).July - August's/men alt.html-
9th January,2008

How to Cite this Article
Pubmed Style

Khilnani AK, Thaddanee R, Khilnani G. Anti vertigo Drugs-Revisited. NJIRM. 2013; 4(4): 118-128.

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Khilnani AK, Thaddanee R, Khilnani G. Anti vertigo Drugs-Revisited. [Access: August 18, 2017].

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Khilnani AK, Thaddanee R, Khilnani G. Anti vertigo Drugs-Revisited. NJIRM. 2013; 4(4): 118-128.

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Khilnani AK, Thaddanee R, Khilnani G. Anti vertigo Drugs-Revisited. NJIRM. (2013), [cited August 18, 2017]; 4(4): 118-128.

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Khilnani, A. K., Thaddanee, R. & Khilnani, G. (2013) Anti vertigo Drugs-Revisited. NJIRM, 4 (4), 118-128.

Turabian Style

Khilnani, Ajeet Kumar, Rekha Thaddanee, and Gurudas Khilnani. 2013. Anti vertigo Drugs-Revisited. National Journal of Integrated Research in Medicine, 4 (4), 118-128.

Chicago Style

Khilnani, Ajeet Kumar, Rekha Thaddanee, and Gurudas Khilnani. "Anti vertigo Drugs-Revisited." National Journal of Integrated Research in Medicine 4 (2013), 118-128.

MLA (The Modern Language Association) Style

Khilnani, Ajeet Kumar, Rekha Thaddanee, and Gurudas Khilnani. "Anti vertigo Drugs-Revisited." National Journal of Integrated Research in Medicine 4.4 (2013), 118-128. Print.

APA (American Psychological Association) Style

Khilnani, A. K., Thaddanee, R. & Khilnani, G. (2013) Anti vertigo Drugs-Revisited. National Journal of Integrated Research in Medicine, 4 (4), 118-128.



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