The effects of betahistine in addition to epley maneuver in posterior canal benign paroxysmal positional vertigo

Otolaryngol Head Neck Surg. 2012 Jan;146(1):104-8. doi: 10.1177/0194599811419093. Epub 2011 Aug 18.


Objective: The purpose of this study is to evaluate the effects of betahistine in addition to Epley maneuver on the quality of life of patients with posterior semicircular canal benign paroxysmal positional vertigo (BPPV) of the canalithiasis type.

Study design: Double-blind, randomized, controlled clinical trial.

Setting: Academic university hospital.

Subjects and methods: Seventy-two patients were enrolled in the study. The first group was treated with Epley maneuver only. The second group received placebo drug 2 times daily for 1 week in addition to Epley maneuver, and the third group received 24 mg betahistine 2 times daily for 1 week in addition to Epley maneuver. The effectiveness of the treatments was assessed in each group as well as between them by analyzing and comparing data of 4 different vertigo symptom scales.

Results: Epley maneuver, alone or combined with betahistine or placebo, was found to be very effective with a primary success rate of 86.2%. The symptoms were significantly reduced in group 3 patients overall, and those patients younger or older than 50 years of age who had hypertension, with symptom onset <1 month, and with attack duration of less than a minute did significantly better with the combination of betahistine 48 mg daily.

Conclusion: Betahistine in addition to Epley maneuver is more effective than Epley maneuver alone or combined with placebo with regard to improvement of symptoms in certain patients. However, future clinical studies covering more patients to investigate the benefit of medical treatments in addition to Epley maneuver are needed.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Benign Paroxysmal Positional Vertigo
  • Betahistine / administration & dosage*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Administration Schedule
  • Female
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities*
  • Posture / physiology*
  • Semicircular Canals / physiopathology*
  • Treatment Outcome
  • Vasodilator Agents / administration & dosage
  • Vertigo / physiopathology
  • Vertigo / therapy*
  • Young Adult


  • Vasodilator Agents
  • Betahistine