Serotonin reuptake inhibitors for dizziness with psychiatric symptoms.
OBJECTIVE
To investigate the efficacy and tolerability of selective serotonin reuptake inhibitors (SSRIs) for the treatment of patients with dizziness and major or minor psychiatric symptoms, with or without neurotologic illnesses.


METHODS
Review of 60 consecutive cases of patients with dizziness who were treated with an SSRI for at least 20 weeks during the 30-month period from July 1998 to December 2000.


METHODS
Tertiary care, multidisciplinary referral center.


METHODS
Sixty men and women, aged 13 to 81 years, with (1) psychogenic dizziness, (2) dizziness due to a neurotologic condition, as well as significant psychiatric symptoms, or (3) idiopathic dizziness.


METHODS
Open-label treatment with an SSRI titrated to 1 of 3 end points: optimal clinical benefit, intolerable adverse effects, or no therapeutic response.


METHODS
Change in dizziness and psychiatric symptoms measured by the 7-point, clinician-rated, Clinical Global Impressions-Improvement Scale.


RESULTS
Thirty-eight (63%) of 60 patients in the intent-to-treat sample and 32 (84%) of 38 patients who completed treatment improved substantially. The response rates did not differ between patients with major psychiatric disorders and those with lesser psychiatric symptoms. Patients whose only diagnosis was a psychiatric disorder and those with coexisting peripheral vestibular conditions or migraine headaches fared better than patients with central nervous system deficits. Before being treated with an SSRI, two thirds of the study patients took meclizine hydrochloride and/or benzodiazepines, with minimal benefit.


CONCLUSIONS
Treatment with SSRIs relieved dizziness in patients with major or minor psychiatric symptoms, including those with peripheral vestibular conditions and migraine headaches. Patients fared far better with SSRI treatment than with treatment with vestibular suppressants or benzodiazepines.
Staab
Jeffrey P
JP
Department of Psychiatry, Hospital of the University of Pennsylvania, Founders Pavilion, F11.015, 3400 Spruce St, Philadelphia, PA 19104, USA. jeffrey.staab@uphs.upenn.edu
Ruckenstein
Michael J
MJ
Solomon
David
D
Shepard
Neil T
NT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000150:complications* / Q000188:drug therapy; D003866:Depressive Disorder / Q000150:complications* / Q000188:drug therapy; D004244:Dizziness / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007759:Labyrinth Diseases / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000188:drug therapy; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D017367:Selective Serotonin Reuptake Inhibitors