New approaches to the management of peripheral vertigo: efficacy and safety of two calcium antagonists in a 12-week, multinational, double-blind study.
OBJECTIVE
To evaluate the efficacy and safety profile of one 30-mg nimodipine oral tablet taken three times per day (one tablet with breakfast, one with lunch, and one with dinner) or one 150-mg cinnarizine verum oral capsule taken once each day with dinner for 12 weeks.


METHODS
Comparative in a double-blind, multinational pilot study.


METHODS
Tertiary referral center.


METHODS
A total of 221 patients met the study criteria; of that total, 181 adult patients completed the study, including 135 women and 46 men whose ages ranged from 20 to 80 years.


METHODS
Two calcium antagonists were used to treat vertigo (nimodipine, 89 patients; cinnarizine, 92 patients), and all patients were maintained on the same dosage regimen until they completed 12 weeks of treatment. Patients were evaluated at 2-and 4-week intervals; an additional evaluation was made at Week 14 to determine vertigo recurrence in the posttreatment period.


METHODS
The response was evaluated by using the vertigo severity index, a count of vertigo episodes in a given time period. Each episode is weighted according to its intensity.


RESULTS
Nimodipine treatment decreased the incidence of moderate vertigo episodes by 78.8% and decreased severe vertigo episodes by 85.0%. Cinnarizine treatment decreased the incidence of moderate vertigo episodes by 65.8% and decreased severe vertigo episodes by 89.8%. Nimodipine and cinnarizine exhibited similar safety profiles. Only two patients withdrew from the study because of adverse events possibly related to the study drug. One patient withdrew from the cinnarizine group because of headache, and one patient withdrew from the nimodipine group because of lipothymia.


CONCLUSIONS
These data confirm the marked efficacy of both nimodipine and cinnarizine in the treatment of vestibular vertigo.
Pianese
Carlo Pane
CP
Instituto Nacional de Neurología y Neurocirugía Dr. Manuel Velasco Suárez de la SSA, Av. Insurgentes Sur #3877, Col. La Famá, México 14269, D.F.
Hidalgo
Lourdes Olivia Vales
LO
González
Ramón Hinojosa
RH
Madrid
Cecilia Esteinou
CE
Ponce
Jorge Enrique Cruz
JE
Ramírez
Alberto Mañé
AM
Morán
Luis Martínez
LM
Arenas
José Enrique Poó
JE
Rubio
Arturo Torres y Gutiérrez
AT
Uribe
Jorge Olguin
JO
Abiuso
José
J
Hanuch
Enrique
E
Alegría
Juan
J
Volpi
Claudio
C
Flaskamp
Renate
R
Sanjuán
Augusto Peñaranda
AP
Gómez
Juan Manuel García
JM
Hernández
Jaime
J
Pedraza
Alvaro
A
Quijano
Diana
D
Martínez
Carolina
C
Castañeda
Juan Ramón
JR
Guerra
Oscar Jorge Cardeñosa
OJ
F
G Valencia
GV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002936:Cinnarizine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004584:Electronystagmography; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009553:Nimodipine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D012008:Recurrence; D012720:Severity of Illness Index; D014717:Vertigo / Q000188:drug therapy* / Q000503:physiopathology
D002121:Calcium Channel Blockers; D002936:Cinnarizine; D009553:Nimodipine