title: Fixed combination of cinnarizine and dimenhydrinate in the prophylactic therapy of vestibular migraine: an observational study.
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%.
authors.affiliation: ENT Division, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy. teggi.roberto@hsr.it.
authors.forename: R
authors.initials: R
authors.lastname: Teggi
authors.affiliation: Department of Neurology, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Colombo
authors.affiliation: ENT Division, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.
authors.forename: O
authors.initials: O
authors.lastname: Gatti
authors.affiliation: Department of Neurology, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Comi
authors.affiliation: ENT Division, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bussi
mesh_terms: D000328:Adult; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002936:Cinnarizine / Q000627:therapeutic use*; D004111:Dimenhydrinate / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014717:Vertigo / Q000188:drug therapy / Q000503:physiopathology; D015837:Vestibular Diseases / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D002121:Calcium Channel Blockers; D004338:Drug Combinations; D006634:Histamine H1 Antagonists; C410867:cinnarizine, dimenhydrinate drug combination; D002936:Cinnarizine; D004111:Dimenhydrinate
keywords: Arlevertan; Calcium blockers; Prophylactic therapy; Vestibular migraine