[Betahistine in vestibular disorders: current concepts and perspectives].

Area of Science:

• Pharmacology
• Neurology
• Otolaryngology

Background:

• Vestibular disorders, including Meniere's disease and benign paroxysmal positional vertigo, significantly impact quality of life.
• Betahistine, a histamine analogue, modulates histamine receptors involved in vestibular function.
• Evidence supports betahistine's efficacy in peripheral vestibular conditions, but its role in central disorders requires further study.

Purpose of the Study:

• To review the pharmacological profile of betahistine.
• To evaluate the evidence for betahistine in treating common vestibular disorders.
• To explore potential new applications and formulations of betahistine.

Main Methods:

• Literature review of pharmacological data and clinical studies on betahistine.
• Analysis of treatment outcomes in peripheral vertigo, Meniere's disease, benign paroxysmal positional vertigo, and vestibular neuritis.
• Comparison of traditional and modified-release betahistine formulations.

Main Results:

• Betahistine is a weak H1 agonist and strong H3 antagonist, demonstrating significant benefits in peripheral vertigo, especially Meniere's disease.
• Optimal results for Meniere's disease were observed with a 48 mg daily dose for 3 months, improving vertigo intensity, attack frequency, and vestibular compensation.
• Betahistine aids in residual dizziness and repositioning maneuvers for BPPV and stimulates central compensation in vestibular neuritis.

Conclusions:

• Betahistine is a valuable treatment for peripheral vestibular disorders, with a new modified-release formulation offering potential adherence benefits.
• Further research is needed to investigate betahistine's efficacy in central vestibular disorders, including post-stroke conditions, persistent postural-perceptual dizziness, and vestibular migraine.
• The pharmacological profile and clinical applications of betahistine continue to be an area of active investigation.