Vertigo

1.       Treatment of vertigo can be classify into several groups as shown in the table below :

2.       In acute phase,  aim of the treatment is to symptomatically control the vertigo by using the treatment listed as below:

-          Anti-emetics (ex: domperidone)

-          Vestibulosedative anti-histamines anti-chollinergic(ex: meclizine,dimenhydinate)

-          Central sedative drugs with vestibule-suppressive or anti-emetic effect (ex: diazepam,sulpiride,dihydrobenzperidol and phenothiazine)

3.       If there is an infection the addition of steroid, antiviral and antibiotic should be consider in this patient.

-          Steroids (ex:prednisone)

-          Antiviral (ex:acyclovir)

-          Antibacterial (ex: amoxicillin)

4.       For the long term treatment, main goals are to prevent or diminish further spells of vertigo, to assist the patient with compensation for the vestibular deficit, to ameliorate or assist with the hearing loss and associated symptoms. The treatment available includes :

-          betahistine - Antihistamine

-          frusemide - diuretic

*all vestibular suppressant or drugs that can make brain feel sleepy are not recommended because it can interfere the vestibular compensation process

5.       Counseling also required for patient in order to improve patient’s quality of life.  Patient can be counselled to reduce salt intake, avoidance of caffeine, alcohol,tobacco, and coping with stress.

Reference

1. http://oto.sagepub.com/content/139/5_suppl/S47.full.pdf+html
2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3444821/
3. http://www.pharmacytimes.com/publications/issue/2009/november2009/hspvertigo-1109