Betahistine: Indications And Precautions

Betahistine is a histamine-regulating drug used to treat vertigo for about 40 years. Other indications such as the treatment of Ménière’s disease and benign paroxysmal positional vertigo (BPPV) have also been investigated.

Although its mechanism of action in Ménière syndrome and BPPV is not entirely clear, according to several authors, it prevents the evolution of this syndrome and progressive hearing loss. In BPPV, it is used as adjunctive therapy for vestibular compensation in recurrent cases of the disease.

On the other hand, the etiology of either Ménière’s syndrome, BPPV, or the other types of peripheral vertigo is still unknown. For this reason, it is not possible to know the exact mechanism by which betahistine and the other drugs that treat these diseases act.

What is vertigo?

Vertigo is not a disease, it is a symptom. Patients who suffer from it feel a false sensation of movement. It usually occurs frequently and can interfere with the activities of daily life of patients.

As we have mentioned, today it is not very well known why this symptom occurs. This type of dizziness is believed to originate in the internal acoustic labyrinth, not in the corresponding neural connections.

Treatment of vertigo requires a multidisciplinary approach that usually includes:

• Pharmacological treatment.
• Physiotherapy sessions.
• Changes in lifestyle.

And Ménière’s syndrome?

This disease is a syndrome that affects the inner ear of the patient. It occurs with episodes of dizziness or vertigo and hearing loss. Usually it affects only one ear, not both.

The pathophysiology of this disease shows a fluid imbalance that leads to altered lymphatic pressures in the inner ear area.

On the other hand, mention that Ménière’s syndrome can develop at any age. However, statistical data indicate that the highest incidence rate occurs between early adulthood and middle age.

Although it is considered a chronic disease, today there are treatments that alleviate symptoms and improve long-term quality of life. Betahistine is believed to regulate capillaries in the inner ear.

In this way, this drug helps to reduce the pressure in the endolymphatic space, as well as to facilitate the reabsorption of endolymphatic fluid.

Main symptoms

This disease has a series of signs and symptoms. Among them we can mention:

• Vertigo: can cause nausea.
• Hearing loss : it can come and go, especially at the beginning. Over time, patients often end up losing their hearing permanently.
• Tinnitus: are the perception of hearing a kind of ringing or buzzing in the ear.
• Sensation of having a blocked ear or auditory congestion.

However, after an episode, the signs and symptoms of this disease usually disappear completely for a time. In addition, these episodes also tend to decrease over time.

How does betahistine exert its effect on the body?

Betahistine owes its effectiveness to its ability to regulate the body’s histaminergic system. It has a histamine H3 receptor antagonist activity and an H1 receptor agonist action. It shows almost no activity against H2 receptors.

Once administered, it reaches the inner ear and there increases the release of neurotransmitters from nerve endings. As a consequence of the interaction with H1 receptors, it produces a powerful vasodilator effect on the inner ear. In this way, the clinical picture of peripheral vertigo improves.

Precautions and Adverse Reactions of Betahistine

When administering this medicine, caution should be exercised in patients with bronchial asthma and / or with a history of peptic ulcer.

In addition, pregnant or lactating women should not take betahistine, as there are no results of studies on the effects of the drug in these situations.

Regarding the adverse reactions produced by this drug, the following should be noted:

• Gastrointestinal problems.
• Nervous system disorders.
• Immune system disorders.
• Skin and subcutaneous tissue problems.

Conclution

Betahistine is a drug that has long been used for its effectiveness in treating vertigos. Like all medicines, it is not without adverse effects, so you should always follow the doctor’s guidelines and do not self-medicate.