Antihistamines are superior to benzodiazepines for the immediate treatment of vertigo.
Vertigo, the sensation of movement associated with nausea or imbalance, affects up to 20% of adults. The incidence is higher among women and seniors.
The primary outcome was change in scores on a 10- or 100-point vertigo or dizziness visual analogue scale 2 hours after treatment. Seven trials that included a total of 802 patients contributed data for the primary outcome. All the trials compared antihistamines with other medications.antihistamines were associated with a 16.1-point greater decrease in vertigo than benzodiazepines. Antihistamines performed similarly to other active comparators, which included dopamine-acting medicines .
"We found that if anything, patients who got the benzodiazepine seemed to do worse than patients who got placebo," said Hunter. Results of four studies that compared Epley repositioning maneuvers alone vs Epley maneuvers in combination with antihistamines for patients with BPPV were mixed. But the largest study, which compared Epley alone vs oralHunter believes repositioning maneuvers are successful in 80% or 90% of cases."They are actually very effective; there aren't too many things in medicine that cure someone 4 out of 5 times.
The investigators"chose an important common clinical problem, systematically searched for relevant evidence, and then assessed the studies for both quality and risk of bias."
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