Medical treatment of vestibular disorders

Expert Opin Pharmacother. 2009 Jul;10(10):1537-48. doi: 10.1517/14656560902976879.


Background: The lifelong prevalence of rotatory vertigo is 30%. Despite this high figure, patients with vertigo generally receive either inappropriate or inadequate treatment. However, the majority of vestibular disorders have a benign cause, take a favorable natural course, and respond positively to therapy.

Objective: This review puts special emphasis on the medical rather than the physical, operative, or psychotherapeutic treatments available.

Methods: A selected review of recent reports and studies on the medical treatment of peripheral and central vestibular disorders.

Results/conclusions: In vestibular neuritis, recovery of the peripheral vestibular function can be improved by oral corticosteroids; in Menière's disease, there is first evidence that high-dose, long-term administration of betahistine reduces attack frequency; carbamazepine or oxcarbamazepine is the treatment of first choice in vestibular paroxysmia, a disorder mainly caused by neurovascular cross-compression; the potassium channel blocker aminopyridine provides a new therapeutic principle for treatment of downbeat nystagmus, upbeat nystagmus, and episodic ataxia type 2.

Publication types

  • Review

MeSH terms

  • Benzodiazepines / therapeutic use*
  • Humans
  • Meniere Disease / drug therapy*
  • Pharmaceutical Preparations
  • Vertigo / etiology
  • Vestibular Diseases / drug therapy*
  • Vestibular Neuronitis / drug therapy*


  • Pharmaceutical Preparations
  • Benzodiazepines