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Fixed combination of cinnarizine and dimenhydrinate in the prophylactic therapy of vestibular migraine: an observational study

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Abstract

Vestibular migraine (VM) is one of the most frequent causes of episodic vertigo, with a lifetime prevalence of 0.98 %. Prophylactic therapy includes calcium channel blockers, beta-blockers, antiepileptic drugs and antidepressants. We studied the association of cinnarizine 20 mg and dimenhydrinate 40 mg (Arlevertan©) in a group of 22 patients affected by definite VM. Proposed therapy included one tablet twice a day for 1 month, which was repeated three times with 1 month of interval between drug intake; results were compared with those of a control group of 11 VM patients who asked to observe only lifestyle measures for migraine. The main outcome was the number of vertigo and headache crises in the 6 months before therapy and in the 6 months of follow-up. Subjects performing Arlevertan© presented during the 6 months of therapy a decrease of vertigo attacks from 5.3 to 2.1 and of headaches from 4.3 to 1.7 (p < 0.0001); 68 % of these subjects reported a decrease of at least 50 % of vertigo attacks, while 63 % of headaches. Conversely, vertigo attacks decreased from 3.5 to 2.2 and headaches from 2.6 to 2 in patients observing only lifestyle; 18 % of these subjects reported a decrease of at least 50 % of vertigo crises and 27 % of headaches. Our data do not differ from those of previous works assessing efficacy of different prophylactic therapies for VM and reporting consistent reduction of vertigo spells in a rate of patients ranging from 60 and 80 %.

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Bibliography

  1. Neuhauser HK, Radtke A, von Brevern M, Feldmann M, Lezius F, Ziese T, Lempert T (2006) Migrainous vertigo. Prevalence and impact on quality of life. Neurology 67:1028–1033

    Article  CAS  PubMed  Google Scholar 

  2. Cass SP, Ankerstjerne JKP, Yetiser S, Furman JM, Balaban C, Aydogan B (1997) Migraine-related vestibulopathy. Ann Otol Rhinol Laryngol 106:182–189

    Article  CAS  PubMed  Google Scholar 

  3. Dieterich M, Brandt T (1999) Episodic vertigo related to migraine (90 cases): vestibular migraine? J Neurol 246:883–892

    Article  CAS  PubMed  Google Scholar 

  4. von Brevern M, Zeise D, Neuhauser H, Clarke AH, Lempert T (2005) Acute migrainous vertigo: clinical and oculographic findings. Brain 128:365–374

    Article  Google Scholar 

  5. Teggi R, Colombo B, Bernasconi L, Bellini C, Comi G, Bussi M (2009) Migrainous vertigo: results of caloric testing and stabilometric findings. Headache 49:435–444

    Article  PubMed  Google Scholar 

  6. Lempert T, Olesen J, Furman J, Waterston J, Seemungal B, Carey J et al (2012) Vestibular migraine: diagnostic criteria. J Vestib Res 22:167–172

    PubMed  Google Scholar 

  7. Bisdorff AR (2011) Management of vestibular migraine. Ther Adv Neurol Disord 4:183–191

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Reploeg MD, Goebel JA (2002) Migraine-associated dizziness: patient characteristics and management options. Otol Neurotol 23:364–371

    Article  PubMed  Google Scholar 

  9. Petkov GV, Fusi F, Saponara S, Gagov HS, Sgaragli GP, Boev KK (2001) Characterization of voltage-gated calcium currents in freshly isolated smooth muscle cells from rat tail main artery. Acta Physiol Scand 173:257–265

    Article  CAS  PubMed  Google Scholar 

  10. Togha M, Ashrafian H, Tajik P (2006) Open-label trial of cinnarizine in migraine prophylaxis. Headache 46:498–502

    Article  PubMed  Google Scholar 

  11. Pianese CP, Hidalgo LO, Gonzalez RH, Madrid CE, Ponce JE, Ramirez AM et al (2002) New approaches to the management of peripheral vertigo: efficacy and safety of two calcium antagonists in a 12-week, multinational, double-blind study. Otol Neurotol 23:357–363

    Article  PubMed  Google Scholar 

  12. Taghdiri F, Togha M, Jahromi SR, Refaejan F (2014) Cinnarizine in the prophylaxis of migraine associated vertigo: a retrospective study. SpringerPlus 3:231

    Article  PubMed Central  PubMed  Google Scholar 

  13. Nicholson AN, Stone BM, Turner C, Mills SL (2002) Central effects of cinnarizine: restricted use in aircrew. Aviat Space Environ Med 73:570–574

    CAS  PubMed  Google Scholar 

  14. Teive HLAG, Troiano AR, Germiniani FMB, Werneck LC (2004) Flunarizine and cinnarizine-induced parkinsonism: a historical and clinical analysis. Parkinsonism Relat Disord 10:243–245

    Article  PubMed  Google Scholar 

  15. Weerts A, Pattyn N, Van de Heyning P, Wuyts F (2013) Evaluation of the effects of anti-motion sickness drugs on subjective sleepiness and cognitive performance of healthy males. J Psychopharmacol 28:655–664

    Article  PubMed  Google Scholar 

  16. Novotný M, Kostrica R (2002) Fixed combination of cinnarizine and dimenhydrinate versus betahistine dimesylate in the treatment of Ménière’s disease: a randomized, double-blind, parallel group clinical study. Int Tinnitus J 8:115–123

    PubMed  Google Scholar 

  17. Scholtz AW, Steindl R, Burchardi N, Bognar-Steinberg I, Baumann W (2012) Comparison of the therapeutic efficacy of a fixed low-dose combination of cinnarizine and dimenhydrinate with betahistine in vestibular neuritis: a randomized, double-blind, non-inferiority study. Clin Drug Investig 32:387–399

    Article  CAS  PubMed  Google Scholar 

  18. Hahn A, Sejna I, Stefflova B, Schwarz M, Baumann W (2008) A fixed combination of cinnarizine/dimenhydrinate for the treatment of patients with acute vertigo due to vestibular disorders : a randomized, reference-controlled clinical study. Clin Drug Investig 28:89–99

    Article  CAS  PubMed  Google Scholar 

  19. Pyykkö I, Schalén L, Jäntti V, Magnusson M (1984) A reduction of vestibulo-visual integration during transdermally administered scopolamine and dimenhydrinate. A presentation of gain control theory in motion sickness. Acta Otolaryngol Suppl 406:167–173

    PubMed  Google Scholar 

  20. Headache Classification Subcommittee of the International Headache Society (2013) The international classification of headache disorders: 3rd edition. Cephalalgia 33:629–808

    Article  Google Scholar 

  21. Rossi P, Fiermonte G, Pierelli F (2003) Cinnarizine in migraine prophylaxis: efficacy, tolerability and predictive factors for therapeutic responsiveness. An open-label pilot trial. Funct Neurol 18:155–159

    PubMed  Google Scholar 

  22. Carmona S, Settecase N (2005) Use of topiramate (topamax) in a subgroup of migraine-vertigo patients with auditory symptoms. Ann N Y Acad Sci 1039:517–520

    Article  CAS  PubMed  Google Scholar 

  23. Bisdorff AR (2004) Treatment of migraine related vertigo with lamotrigine an observational study. Bull Soc Sci Med Grand Duche Luxemb 2:103–108

    PubMed  Google Scholar 

  24. Baier B, Winkenwerder E, Dieterich M (2009) Vestibular migraine: effects of prophylactic therapy with various drugs. A retrospective study. J Neurol 256:436–442

    Article  PubMed  Google Scholar 

  25. Maione A (2006) Migraine-related vertigo: diagnostic criteria and prophylactic treatment. Laryngoscope 116:1782–1786

    Article  PubMed  Google Scholar 

  26. Reploeg MD, Goebel JA (2002) Migraine associated dizziness: patients characteristics and management options. Otol Neurotol 23:364–371

    Article  PubMed  Google Scholar 

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Teggi, R., Colombo, B., Gatti, O. et al. Fixed combination of cinnarizine and dimenhydrinate in the prophylactic therapy of vestibular migraine: an observational study. Neurol Sci 36, 1869–1873 (2015). https://doi.org/10.1007/s10072-015-2270-6

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  • DOI: https://doi.org/10.1007/s10072-015-2270-6

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