Treatment of acute vestibular vertigo

The alleviation of vestibular distress using drug therapy is a question of whether treatment with drugs is advisable at all or whether more emphasis should be directed towards active habituation therapy. Histamine and especially its derivative, betahistine, inhibit the massive impulses to the polysynaptic neurons of the lateral vestibular nucleus without having any sedative effect, as measured by saccadic eye movements. In the ENT Clinic of Turku University Hospital, betahistine has been used to treat 613 Meniere's patients at a dose of 8 mg three times daily. In about 80% of these patients, the results of therapy were positive. Betahistine is the current most effective drug in maintenance therapy of Meniere's disease, although it does not resolve all of the problem of this disorder. Betahistine can also be used in other forms of vestibular vertigo as maintenance therapy, because it only has minimal side-effects and it has not been shown to slow down habituation.