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

Autor: Zamergrad MV; Russian Medical Academy of Continuous Professional Education, Moscow, Russia.; Russian Gerontology Clinical Research Center of Pirogov Russian National Research Medical University., Kunelskaya NL; Russian Gerontology Clinical Research Center of Pirogov Russian National Research Medical University.; Sverzhevsky Research Institute of Clinical Otorhinolaryngology, Moscow, Russia., Guseva AL; Russian Gerontology Clinical Research Center of Pirogov Russian National Research Medical University., Amelin AV; Pavlov First St. Petersburg State Medical University, St. Petersburg, Russia., Lilenko SV; Saint Petersburg ENT and Speech Research Institute, St. Petersburg, Russia.; North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia., Samartcev IN; Kirov Military Medical Academy, St. Petersburg, Russia., Zaytseva OV; Scientific and Clinical Center of Otorhinolaryngology of the Federal Medico-Biological Agency of the Russian Federation, Mosco, Scientific and Clinical Center of Otorhinolaryngology of the Federal Medico-Biological Agency of the Russian Federation, Moscow., Melnikov OA; Center of vertigo and balance disorders, GUTA CLINIC, Moscow, Russia., Voronov VA; North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia., Lyapin AV; Federal Siberian Research Clinical Centre under the Federal Medical Biological Agency, Krasnoyarsk, Russia.
Jazyk: ruština
Zdroj: Vestnik otorinolaringologii [Vestn Otorinolaringol] 2021; Vol. 86 (2), pp. 73-81.
DOI: 10.17116/otorino20218602173
Abstrakt: The goal of this paper is to review the pharmacological profile of betahistine and evidence for using it in the treatment of common vestibular disorders. Betahistine is a weak agonist for histamine H1 receptors and strong antagonist for histamine H3 receptors. It demonstrates the maximum benefit in different types of peripheral vertigo, especially in Meniere's disease. The best results in decreasing intensity of vertigo, frequency of attacks and stimulation of vestibular compensation were obtained in daily dose 48 mg during 3 months. In benign paroxysmal positional vertigo betahistine is used to treat residual dizziness after successful treatment of otolithiasis and to reduce the severity of vertigo during repositioning maneuvers. In vestibular neuritis betahistine stimulates central compensation during vestibular rehabilitation. A new once-daily drug formulation of modified-release betahistine is non-inferior to traditional and has a comparable safety profile, and could improve patient adherence. The implication of betahistine in the treatment of central vestibular disorders is under-researched. The efficacy of betahistine in increasing of vestibular compensation in post-stroke central vestibular disorders, persistent postural-perceptual dizziness and its role in vestibular migraine need further investigation.
Databáze: MEDLINE