Betaistine: Indications And Precautions

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

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

On the other hand, the etiology of Ménière’s syndrome, BPPV and other types of peripheral vertigo is not yet known. For this reason, it is not possible to determine the exact mechanism of action of betahistine or other drugs that treat these conditions.

What is vertigo?

Vertigo is not a disease but a symptom. Patients with this symptom experience a false sense of movement. It tends to occur frequently and can interfere with the patients’ daily activities.

As mentioned, it is currently unknown why this symptom occurs. This type of dizziness is believed to originate from the internal acoustic labyrinth, not from the corresponding neural connections.

The treatment of vertigo requires a multidisciplinary approach that usually includes:

• Pharmacological treatment.
• Physiotherapy sessions.
• Lifestyle changes.

And what about Ménière’s syndrome?

This disease is a syndrome that affects the patient’s inner ear. Occurs with episodes of dizziness or vertigo and hearing loss. It usually only affects one ear, not both.

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

On the other hand, it is worth mentioning that Ménière’s syndrome can develop at any age. However, statistical data indicate that the highest percentage of incidence occurs between early adulthood and middle age.

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

Thus, this drug helps to reduce pressure in the endolymphatic space and also facilitates the reabsorption of endolymphatic fluid.

Main symptoms

This disease causes a number of signs and symptoms. Among them, we can mention:

• Dizziness: can cause nausea.
• Hearing loss: can appear and disappear, especially at first. Over time, patients often end up permanently losing their hearing.
• Tinnitus: is the perception of hearing a type of tinnitus or ringing in the ear.
• Sensation of obstructed ear or auditory congestion.

However, after an episode, the signs and symptoms of this disease usually disappear completely for a while. In addition, these episodes also tend to diminish 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 an antagonistic activity on histamine H3 receptors and an agonistic action on H1 receptors. It has almost no activity against H2 receptors.

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

Precautions and adverse reactions of betahistine

When administering this drug, caution is recommended in patients with bronchial asthma and/or a history of peptic ulcer disease.

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

Regarding the adverse reactions produced by this drug, it is important to highlight the following:

• Gastrointestinal problems.
• Disorders of the nervous system.
• Disorders of the immune system.
• Skin and subcutaneous tissue problems.

Conclusion

Betahistine is a drug used for a long time for its effectiveness in the treatment of vertigo. Like all medications, it is not free from adverse effects. Therefore, doctor’s guidelines should always be followed and we should never self-medicate.