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PubMed1997

Physiopathology of H3-receptors and pharmacology of betahistine.

This article reviews published research on the physiology of histamine H3-receptors. The function of this inhibitory autoreceptor, its localisation and influence on histaminergic neurones as well as histamine-controlled processes are presented together with the role of H3-receptors in the vestibular system. In addition to a summary of the properties of the main H3-agonists and -antagonists, the pharmacology of betahistine and its place in the treatment of vertigo are discussed.

Animals↗
PubMedDate not supplied

[Treatment of vertigo with betahistine and its clinical and electrophysiological evaluation].

Betahistine was administered during 4 weeks to 31 patients with vertigo, divided into 3 groups depending on changes in neurological examination. 1 group--13 patients without abnormalities, 2 group--11 with ischemia vertebrobasilaris, 3 group--7 with lesion of VIII nerves. Significant improvement was obtained in 20 patients (65%), most evident in group 1 (in 11). BAEP examination revealed abnormalities in 12 cases before the treatment and recovery in 4 (33.3%) after 4 weeks of treatment. They were: longer latency of the 1 component (39%), and III and V components mainly in the group with baso-vertebral ischemia. It confirms the supposition that disturbances of microcirculation are responsible for the mechanism of vertigo in these cases.

Adult↗
PubMed2001

The pharmacology of betahistine in the context of the vestibular system.

The problem of deciding, which, of several drug actions is the 'true' mechanism of action is an ancient and difficult one in pharmacology. Sometimes the problem is that each investigator may see his described action as through a tunnel, his vision not encompassing other possibilities. To help with the process of deciding the 'true' mechanism of action, the pharmacologist Philip Seeman has offered some guidelines. A few of his guidelines apply in the case of betahistine (BH). One is--does the drug have access to the proposed site of action? A second is--are the concentrations at which the drug acts at the candidate mechanism achievable in the patient? The three candidate sites of BH action are vascular, central nervous system and inner ear. There is obvious evidence that a vascular site as well as a vestibular end organs site are possible. There is also evidence that BH gains access to the central nervous system albeit achieving lower concentrations there than in plasma. Whether BH crosses the blood-labyrinthine barrier is not known. Then there is the guideline of similarity of clinically-achievable and experimental concentrations. Implicit in this guideline, without data to the contrary, is the assumption that the plasma concentration of a drug is roughly the concentration at the active site. This may or may not be true.

Betahistine↗
PubMedDate not supplied

Betahistine inhibits food intake in rats.

Betahistine, administered intraperitoneally, decreased, in a dose-dependent manner and in a statistically significant degree, total food intake in different experimental models in rats.

Animals↗
PubMed1975

Clinical trials of betahistine hydrochloride in the treatment of Ménière's disease.

Thirty Ménière patients were treated with betahistine hydrochlorid for an average period of 17 months. The majority of them had been resistent to every previous treatment. The results of this new treatment were very gratifying with respect to the attacks of vertigo and the accompanying neuro-vegetative symptoms. The tinnitus aurium proved to be resistent, whereas the auditory acuity was significantly improved in 7 patients. Early treatment with this product at the first signs of Ménière's disease is very likely to hold up the progressive degradation of auditory acuity, during the further spontaneous evolution of the disease.

Betahistine↗
PubMed2004

Betahistine in vertebrobasilar insufficiency.

The aim of this study was to observe the usefulness of betahistine dihydrochloride--Betaserc--in therapy for vestibular disorders in patients with vertebrobasilar insufficiency. Two groups of patients, in each of which were 150 patients (mean age, 52.2 years), were tested on the basis of videonystagmography and stabilometry. Betaserc was administrated in two separate doses: 8 mg three times daily and 16 mg three times daily for 120-180 days (mean, 132 days). In every case before and after therapy, visuo-oculomotor and vestibulo-oculomotor reflexes were tested, and amplitude and velocity of the sway were measured during dynamic posturographic testing. After Betaserc treatment, pathological visuo-oculomotor reactions and pathological cervical test results disappeared in most cases: Smooth pursuit improved in 59.9% of cases and saccadic movements in 55.9% of patients, and cervical nystagmus disappeared in 62.2% of tested people. During stabilometry, mean and maximal platform amplitude and mean head velocity decreased as compared with results from tests performed before treatment. These observations were significant after the greater dose of Betaserc; nonetheless, improvement was noted after both doses. The usefulness of Betaserc in vertebrobasilar insufficiency was proved, 4-6 months' therapy was sufficient, and the effect on central compensation seemed to be most probable.

Adult↗
PubMed1988

Flunarizine and betahistine. Two different therapeutic approaches in vertigo compared in a double-blind study.

One hundred and seventeen adult patients suffering from vestibular vertigo were treated in a multicentre double-blind study with flunarizine (10 mg before sleeping) or betahistine dichlorhydrate (8 mg 3 times daily). The study took 2 months. The results revealed that flunarizine is significantly more active against attacks of vertigo and associated symptoms (mainly neurovegetative disorders, anxiety and headaches). The global superiority of flunarizine was confirmed by both the evaluation by the investigators and the patient. Significantly fewer patients treated with flunarizine reported side effects or interrupted the trial therapy prematurely. This study confirms the value of the calcium antagonist flunarizine in the treatment of vestibular vertigo.

Adult↗
PubMed1983

[Clinical experiences with betahistine].

50 patients with disorders of the cochleo-vestibular system due a wide variety of causes were treated with Betahistine (Betaserc). The reaction of Betaserc was different in vertigo, tinnitus and hearing loss. As expected, the result of the treatment depends on kind and duration of the disease. Best results were found for M. Ménière. Summarizing Betaserc can be said to be most effective in treating vertigo, less effective in treating tinnitus, but inappropriate in treating hearing loss.

Adult↗
PubMed1978

[Betahistine treatment of Menière's disease (author's transl)].

An evaluation of Betahistine hydrochloride treatment of 92 patients suffering from Menière disease and Menière-like syndrom is presented. Observed for more than one year 54 (89%) patients showed complete relief of vertigo-attack symptoms. 7 (12%) patients showed a distinct improvement in their hearing as reflected in their audiograms, only 7 (12%) patients showed a further loss of hearing. There appeared to be a trend toward further improvement when therapy was maintained over at least a period of 3--4 month. Vertigo seemed to be the symptom most responsive to treatment and tinnitus the most resistant. Minimal side effects were observed in 17 (18%) patients.

Betahistine↗
PubMed1977

Rheoencephalographic and other studies of betahistine in humans. III. Improved methods of diagnosis and selection in arteriosclerotic dementia.

Thirty-six institutionalized geriatric patients with particularly severe and longstanding dementia were selected by chart review and were studied neurologically. Criteria for clinical diagnosis are derived, and it is shown that arteriosclerosis had caused or contributed to their dementias in 33 patients (91.7%) and probably did so in two others (97.2%). Arteriosclerotic dementia may not be rare and may be much more prevalent than may now be considered the case. As 23 patients (63.9%) showed evidence of carotid and/or vertebrobasilar involvement, large-vessel disease also may be more prevalent in geriatric dementia than is now thought and should be considered in all such patients. The results further confirm that careful review of ward records without reference to psychiatric diagnoses of etiology is a simple, rapid, and reliable method of screening a large institutionalized population for possible arteriosclerotic dementia. The selectees should then be surveyed appropriately to confirm the presence of the disease. Since a careful review of the complete hospital records and a thorough neurologic examination proved sufficient, more definitive but more dangerous invasive diagnostic procedures may not be necessary for clinical pharmacologic and similar investigations.

Aged↗