Pharmacological basis of drug therapy for vertigo

Abstract

In the acute period, the goal of drug therapy for vertigo is suppressing the sensation of vertigo, preventing vomiting and helping restore normal balance. Intravenous injection of NaHCO3 is effective against the sensation of vertigo. Since histamine H1-receptors are involved in vomiting that is associated with vertigo, antihistamines could prevent it. Benzodiazepines may restore normal balance by stimulating the initial development of vestibular compensation, in addition to their antianxiety effects. In the chronic period, vasodilators such as diphenidol or betahistine could prevent recurrent attacks of vertigo. Benzodiazepines may act on the limbic system and relieve psychotic triggering of vertigo attacks. Meniere's disease, in which the primary pathology is endolymphatic hydrops, is specifically managed by an osmotic diuretic, isosorbide. Steroids may be helpful in patients with vestibular neuronitis.