title: Influence of an antivertiginous combination preparation of cinnarizine and dimenhydrinate on event-related potentials, reaction time and psychomotor performance--a randomized, double-blind, 3-way crossover study in healthy volunteers.
abstract: In the present comparative, double-blind, 3-way crossover study, possible effects of an antivertiginous combination preparation on event-related potentials (ERPs) and performance were investigated. Twenty-one healthy volunteers received 4 doses (within 24 h) of a fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg (Arlevert, ARL), dimenhydrinate 50 mg, or a placebo, in randomized order at 1-week intervals. Auditory event-related potentials (ERPs), reaction time (RT) and psychometric tests were assessed before as well as 60 and 150 minutes after the intake of the 1st (Day 1) and the 4th (Day 2) dose of study medication. The evaluation was primarily based on the difference in the outcomes measured 150 min after the 4th dose (t5) and those before the start of medication intake (t0). None of the medications affected the latency and amplitude of the sensory ERP component N100, neither under passive listening nor under discrimination task conditions. The latency of P300 in response to the rare target tones (oddball paradigm and binary series), showed significant (p < 0.05) delays after 4 doses of dimenhydrinate (18-24 ms), and no significant differences between ARL (3-17 ms) and either dimenhydrinate or placebo (4-13 ms). Responses to nontarget tones remained almost unaffected after medication intake. The secondary analysis of the P300 amplitude showed the greatest decreases under DH in both active series, with no significant differences between ARL and either DH or placebo. The 3 medications did not significantly prolong RT nor did they impair the performance of psychometric tests, or cause significant shifts of current mood. The combination preparation ARL showed the lowest rate of adverse events (n = 1), followed by dimenhydrinate (n = 3) and placebo (n = 6). Two subjects withdrew because of adverse events, both after the intake of placebo. In conclusion, the results gave no evidence for an impairment of central information processing and psychomotor performance after multiple dosing with the fixed combination ARL in healthy volunteers, which might, when present, represent an adverse reaction limiting its use in antivertiginous therapy. No significant differences were found between ARL and placebo.
authors.affiliation: Institute of Physiology, Laboratory of Motor Control, Bulgarian Academy of Sciences, Sofia, Bulgaria.
authors.forename: D
authors.initials: D
authors.lastname: Philipova
authors.forename: B
authors.initials: B
authors.lastname: Tzenova
authors.forename: A
authors.initials: A
authors.lastname: Iwanowitsch
authors.forename: I
authors.initials: I
authors.lastname: Bognar-Steinberg
mesh_terms: D000328:Adult; D002936:Cinnarizine / Q000008:administration & dosage / Q000494:pharmacology*; D018592:Cross-Over Studies; D004111:Dimenhydrinate / Q000008:administration & dosage / Q000494:pharmacology*; D004311:Double-Blind Method; D004338:Drug Combinations; D005072:Evoked Potentials, Auditory / Q000187:drug effects; D005260:Female; D006634:Histamine H1 Antagonists / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D008297:Male; D011594:Psychometrics; D011597:Psychomotor Performance / Q000187:drug effects*; D011930:Reaction Time / Q000187:drug effects*; D014717:Vertigo / Q000188:drug therapy
chemical_list: D004338:Drug Combinations; D006634:Histamine H1 Antagonists; D002936:Cinnarizine; D004111:Dimenhydrinate