Betahistine: Indications And Precautions

Caution should be exercised when administering this drug in patients with bronchial asthma and / or with a history of peptic ulcer.

Betahistine is a  histamine regulator drug that has been used for the treatment of dizziness  for about 40 years. Other indications such as the treatment of Ménière’s disease and benign paroxysmal postural vertigo (BPPV) have also been studied.

Even if its mechanism of action in Ménière’s syndrome and BPPV is not entirely clear, according to various authors, it nevertheless prevents the development of this syndrome as well as progressive hearing loss. In the case of BPPV it is used as adjuvant therapy for vestibular compensation in recurrent cases of the disease.

However, the etiology of Ménière’s syndrome, BPPV or other types of peripheral vertigo is not yet known. Therefore, the exact mechanism of action of betahistine and other drugs that treat these conditions is unknown .

What is vertigo?

Vertigo is not a disease, but rather a symptom. Patients who suffer from it experience a mistaken sense of movement. It comes on regularly and can interfere with a person’s daily activities.

As we mentioned, today  we do not know the causes of this symptom. It is believed that this type of vertigo occurs in the internal acoustic labyrinth, and not in the corresponding neural connections.

The treatment of vertigo requires a multidisciplinary approach which generally includes:

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

What about Ménière’s syndrome?

This disease is a syndrome that affects a person’s inner ear. It is manifested by episodes of dizziness and hearing loss. Usually it affects only one ear.

The pathophysiology of this disease highlights an imbalance of fluids  which leads to an alteration of lymphatic pressures in the inner ear area.

In addition, it is important to specify that Ménière’s syndrome can occur at any age. However, statistical data indicate that the highest percentage of incidence is between early adulthood and middle age.

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

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

The main symptoms

This disease manifests itself through a series of signs and symptoms. Among which we can mention:

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

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

How does betahistine work in the body?

Betahistine  owes its effectiveness to its ability to regulate the body’s histaminergic system. It exhibits antagonist activity on histamine H3 receptors as well as an agonist action on H1 receptors. It has virtually no activity on H2 receptors.

Once administered, it reaches the inner ear. Then  increases the release of neurotransmitters from the nerve endings. As a result of the interaction with the H1 receptors, this produces a potent vasodilator effect on the inner ear. It thus improves the clinical picture of peripheral vertigo.

Precautions and Adverse Reactions of Betahistine

Caution is advised when administering this medication  in patients with bronchial asthma and / or with a history of peptic ulcer disease.

On the other hand,  pregnant or breastfeeding women should not ingest betahistine. Because there are no results of studies on the effects of this drug in this kind of situations.

Regarding the adverse reactions produced by betahistine, we can cite the following:

• Gastrointestinal issues
• Nervous system disorders
• Neurological system disorders
• Skin and subcutaneous problems

Conclusion…

Betahistine is a drug that has been used for a very long time because of its effectiveness in treating dizziness. Like other medications, it is not without side effects. It is therefore always a good idea to follow the doctor’s instructions and not to self-medicate.