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At least 145 records · Page 8Linked to original sources
PubMed1981

[Study of a programmed release preparation of betahistine mesylate in the treatment of Ménière's disease (author's transl)].

The efficacy/tolerance ratio of a new form of betahistidine salt was studied in patients with Ménière's disease or isolated tinnitus. The study was divided into two stages: first, a conventional open trial, then a comparative cross-over trial. Analysis of efficacy scores showed that the drug was clearly effective in relieving vertigo and associated symptoms and had no clinical or biochemical side-effects.

Adult↗
PubMed2000

Medical treatment in Ménière's disease: avoiding vestibular neurectomy and facilitating postoperative compensation.

The efficacy of medical treatment in preventing the need for vestibular neurectomy (VN) in patients with disabling Ménière's disease, and in facilitating postoperative compensation of equilibrium after VN, was investigated. Ninety-five patients with classic symptoms of unilateral incapacitating Ménière's disease were included. Patients were treated with either 16 mg betahistine three-times daily (n = 49) or 125 mg acetazolamide once-daily (n = 46) for 6 months. The study showed that marked benefit was achieved in 51 of the 95 patients, of whom significantly more were in the betahistine group than in the acetazolamide group [32 (65%) vs 19 (41%); p < 0.05]. Twenty-seven patients in the acetazolamide group and 17 in the betahistine group experienced no benefit from medical treatment and therefore underwent VN. Twelve patients in the betahistine group and 6 in the acetazolamide group eventually experienced a relapse and thus also underwent VN. Therefore 62 patients in total underwent VN. Following surgery, patients were given medical treatment in an attempt to facilitate vestibular compensation; 28 received betahistine (16 mg three-times daily) and 34 received cinnarizine (25 mg three-times daily) for 3 months. The patients treated with betahistine had a shorter period of disability and significantly better results on rotatory testing. In conclusion we recommend the use of betahistine in patients who have undergone VN.

Acetazolamide↗
PubMed2000

The effect of blood flow promoting drugs on cochlear blood flow, perilymphatic pO(2) and auditory function in the normal and noise-damaged hypoxic and ischemic guinea pig inner ear.

The effect of blood flow promoting drugs, such as hydroxyethyl starch (HES) either of low or high molecular weight (HES 70, HES 200), pentoxifylline, ginkgo biloba, naftidrofuryl and betahistine, and various combinations of the drugs was studied in unexposed and noise-exposed (broad-band noise, bandwidth 1-12 kHz, 106 dB SPL, 30 min) guinea pigs. The results were compared without therapy and placebo (isotonic saline, NaCl). The cochlear blood flow (CoBF) and the partial pressure of oxygen in the perilymph (PL-pO(2)) were continuously and simultaneously recorded over a period of 210 min. In addition, cochlear microphonics (CMs), compound action potentials of the auditory nerve (CAPs) and auditory brain stem responses (ABRs) were registered. Noise-induced hearing loss (NIHL) paralleled a decrease of PL-pO(2). Both were found to occur before evidence of reduced CoBF. PL-pO(2) and CoBF declined progressively post-exposure, while CMs, CAPs and ABRs showed no further deterioration or signs of recovery up to 180 min after cessation of noise. Treatment started 60 min post-exposure, respectively after 90 min, without manipulation in unexposed animals, and was then studied for a further 120 min. In unexposed animals, CoBF increased significantly during infusion of HES 70, HES 200, pentoxifylline and betahistine. NaCl, ginkgo biloba and naftidrofuryl did not alter CoBF. PL-pO(2) decreased significantly during infusion of all administered drugs and combinations, except for NaCl. CMs, CAPs and ABRs remained constant, with the exception of increased ABRs after infusion of HES 70 and HES 200. In noise-exposed animals, a sustained therapeutic effect on cochlear ischemia was achieved only by HES 200 and pentoxifylline. HES 70, betahistine and ginkgo biloba compensated cochlear ischemia only during infusion; however, 30-60 min after termination of therapy, no significant difference of values for CoBF was observed compared to the untreated noise-exposed groups. NaCl and naftidrofuryl showed no effect on CoBF. None of the applied drugs had a sustained compensatory effect on cochlear hypoxia. CMs, CAPs and ABRs improved significantly after HES 70, HES 200 and betahistine, resulting in partial recovery of CMs, and partial (betahistine) or even full (HES 70 and HES 200) recovery of CAPs and ABRs. In contrast, NaCl, pentoxifylline, ginkgo biloba and naftidrofuryl had no therapeutic effect on NIHL.

Animals↗
PubMed2000

Vestibular compensation in the cat: the role of the histaminergic system.

Histamine is thought to be involved in the recovery of vestibular function as histaminergic medications are effective in vestibular-related syndromes. We conducted studies in the cat to assess the effects of betahistine (a histamine-like substance) on the behavioural recovery process after unilateral vestibular neurectomy (UVN). We also investigated histamine immunoreactivity changes in the vestibular and tuberomammillary nuclei of betahistine-treated lesioned cats compared with untreated and unlesioned cats. Betahistine strongly accelerated the behavioural recovery process after UVN, with a time benefit of approximately 2 weeks for both static posture (support surface) and dynamic equilibrium function (locomotor balance) compared with untreated animals. A bilateral decrease in histamine immunoreactivity was seen in both acute and compensated UVN cats; this effect was strongly accentuated with betahistine treatment. In conclusion, the results indicate that vestibular lesion reduces histamine staining due to an increase in histamine release in the vestibular and tuberomammillary nuclei that promote vestibular recovery. Betahistine dihydrochloride should contribute to this process by acting on both the presynaptic histamine H3 and postsynaptic histamine H1 receptors.

Adaptation, Physiological↗
PubMed2003

Influence of 3 antivertiginous medications on the vigilance of healthy volunteers.

In the present randomized, comparative, double-blind, 3-way crossover study, possible effects of 3 antivertiginous medications on vigilance were investigated. 30 healthy volunteers received single doses of a fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg (Arlevert, ARL), dimenhydrinate 50 mg, or betahistine dimesylate 12 mg, in randomized order at 1-week intervals. Spontaneous brain electrical activity (EEG), acoustic late evoked potentials (ALEP) with P300, and reaction time were measured before and 90 (t90) and 180 minutes (t180) after drug intake. All 3 medications led to a delay of P300 (primary criterion) and a decrease of its amplitude. The maximum delay at t180 was found for dimenhydrinate (16.42 ms) and the lowest for betahistine (6.33 ms). Differences ARL vs dimenhydrinate and ARL vs betahistine were not statistically significant (p > 0.05). Spectral analysis of spontaneous EEG showed slight and similar decreases in the power in the a-band under dimenhydrinate and ARL (p = 0.07 and p = 0.03 with respect to baseline, respectively), but basically no change under betahistine. There was no effect on reaction time by either medication. None of the subjects reported drowsiness or any other adverse event. The findings confirm the reported suitability of P300 latency for measurement of drug effects on brain activity, but provide no indication of concomitant impairment of performance capacity by the tested drugs. Global assessment of the results suggests that the fixed combination cinnarizine 20 mg/dimenhydrinate 40 mg exerts only a minor effect on vigilance, not significantly different from betahistine, which is commonly regarded as a non-sedating antivertiginous drug

Adolescent↗
PubMed1993

Influence of histamine receptor antagonists on the dynamics of the cutaneous hypersensitivity reaction in patients infected with schistosoma haematobium.

The biphasic cutaneous hypersensitivity response elicited by intradermal administration of S. haematobium antigen to patients with schistosomiasis may be used as a model for drug effects on cell dynamics. As the effects of H1- and H2-blockade, and the possible involvement of H3-receptors, have not been elucidated, we have examined the effects of combinations of cetirizine, cimetidine and betahistine on the response of patients with confirmed schistosomiasis. The skin blister technique was used. After intradermal administration of antigen, blister fluid containing inflammatory cells was collected on microscope slides at 6 and 24 h, and a differential cell count was done; and the area of induration was measured at 0.25, 1, 6 and 24 h. These baseline tests were repeated after 3 days of pretreatment with cetirizine 20 mg/d, after the addition of cimetidine 1200 mg/d for 3 further days, and finally after adding on betahistine 32 mg/d for 3 days. Simultaneous H1- and H2-blockade with cetirizine plus cimetidine caused a significantly greater reduction in induration than cetirizine (H1-blockade) alone; the reductions from the baseline value were 70%, 78%, 89%, 97%, and 33%, 53%, 43%, 30%, at times 0.25, 1, 6 and 24 h, respectively. The triple combination with the addition of betahistine (H1- and H2-agonist and H3-antagonist) resulted in reductions of 37%, 63%, 95% and 97% at the same times. The most striking changes in cellular dynamics were a significant increase in eosinophil (6 h) and neutrophil (6 h) vacuolation, and enhancement of monocyte (24 h) and basophil (6 h) accumulation, when the betahistine was added.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1996

Postmarketing study of the use of flunarizine in vestibular vertigo and in migraine.

OBJECTIVE: This international postmarketing observational study of flunarizine was designed to evaluate, in routine clinical practice, the risk/benefit ratio of flunarizine in its approved indications, namely prophylaxis of migraine and treatment of vertigo. Comparator drugs were propranolol in migraine and betahistine in vertigo. The study was carried out by 498 general practitioners in Belgium, The Netherlands and Germany, whose participation had been requested by mail. In total 3186 patients were entered: 1601 in the two migraine cohorts and 1585 in the two vertigo cohorts. RESULTS: In the migraine study, treatment results with propranolol tended to be somewhat better than those with flunarizine, but a selection bias cannot be excluded. There was no clear difference regarding efficacy between flunarizine and betahistine in the vertigo study. The safety evaluation focused on extrapyramidal symptoms (EPS) and depression. Overall, EPS were noted in only four patients, two in the vertigo-betahistine and two in the migraine-flunarizine cohort. A total of 70 patients developed depressive symptoms (34 in the flunarizine and 24 in the propranolol migraine cohorts, but only 7 in the flunarizine and 5 in the betahistine vertigo cohorts). Patients with migraine were clearly more prone to depression than patients with vertigo, regardless of their treatment. Additional risk factors for depression were a history of depression, and, in the migraine flunarizine cohort, a high number of previous migraine treatments.

Basal Ganglia Diseases↗
PubMed1997

Histamine immunoreactivity changes in vestibular-lesioned and histaminergic-treated cats.

Histamine is likely involved in vestibular function recovery since histaminergic medications are effective in vestibular-related syndromes. We investigated the histamine immunoreactivity changes after unilateral vestibular neurectomy and the effects of betahistine (a partial histamine H1 receptor agonist and an histamine H3 receptor antagonist) and thioperamide (a pure histamine H3 receptor antagonist) treatment in cats. Histamine staining was analyzed in the tuberomammillary and vestibular nuclei through immunohistochemical methods and quantification techniques in light microscopy. Unilateral vestibular neurectomy induced a strong bilateral decrease in histamine immunoreactivity in the vestibular nuclei and a smaller reduction in the tuberomammillary nuclei in both acute (1 week) and compensated (3 weeks, 1 year) cats. One-week thioperamide or betahistine treatment led to a near-total lack of staining in these structures in both lesioned and control cats. One-month betahistine treatment had weaker effects in the compensated cats. We conclude that vestibular lesions reduce histamine staining because of an increase in histamine release in the vestibular and tuberomammillary nuclei, promoting vestibular functions recovery, and betahistine could contribute to this process by acting on both the presynaptic histamine H3 and postsynaptic histamine H1 receptors.

Animals↗
PubMed1991

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.

Acute Disease↗
PubMed1998

Homeopathic vs conventional treatment of vertigo: a randomized double-blind controlled clinical study.

OBJECTIVE: To compare the efficacy and safety of a homeopathic remedy (Vertigoheel, Heel Inc, Albuquerque, NM) vs betahistine hydrochloride (active control) in the treatment of patients with vertigo of various origins in a confirmative equivalence trial. DESIGN: Randomized (1:1) double-blind controlled clinical trial. SETTING: Fifteen study centers (general practice) in Germany between November 1995 and November 1996. SUBJECTS: A total of 119 patients with vertigo of various origins (from whom 105 patients could be analyzed as intended per protocol). MAIN OUTCOME MEASURES: Frequency, duration, and intensity of vertigo attacks. RESULTS: Both homeopathic and conventional treatments showed a clinically relevant reduction in the mean frequency, duration, and intensity of the vertigo attacks. The therapeutic equivalence of the homeopathic remedy and betahistine was established statistically. CONCLUSIONS: Concerning the main efficacy variable, therapeutic equivalence between the homeopathic remedy and betahistine could be shown with statistical significance (confirmative analysis). Both remedies reduced the frequency, duration, and intensity of vertigo attacks during a 6-week treatment period. Also, vertigo-specific complaints were significantly reduced in both treatment groups.

Adolescent↗
PubMed1994

Histamine receptors in the human nose.

The aim of this study was to determine the role of histamine receptors in the nose. The effects of intranasal histamine challenge were compared with those of a specific H1-receptor agonist, betahistine and a specific H2-receptor agonist, impromidine, in 11 normal individuals and four with rhinitis. Sneezing, nasal irritation and hypersecretion were induced by histamine and the H1-receptor agonist, betahistine only. Nasal airway resistance (Rna) was measured by passive anterior rhinomanometry. Histamine, betahistine and impromidine all induced rises in Rna in both normal individuals and those with rhinitis but histamine had the most potent effect; the H2-receptor effect on Rna was predominant over that of the H1-receptor. The sensitivity to all three agonists was greater in the individuals with rhinitis.

Adult↗