Treatment of dizziness in elderly patients with chronic cerebrovascular pathology

Author:
S.N. DUMA

Research Institute of Therapy and Preventive Medicine-a branch of the Federal State University "Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences", Novosibirsk, Russia

Place of publication:
JOURNAL OF NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS, 1, 2018

Abstract:
Dizziness in elderly patients can be caused by various reasons, drug treatment options are limited, and betahistine dihydrochloride is most commonly used. The aim of the study was to evaluate the efficacy and safety of combination therapy with Mexidol®and betahistine in patients with dizziness, as assessed by the Global Assessment of Treatment Effectiveness scale. Patients and methods. The study included 89 elderly patients (mean age 73.7 years) with chronic cerebrovascular pathology and complaints of dizziness. All patients underwent neurological, otoneurological (orthostatic test, forced hyperventilation test, Dix-Hallpike test, Tinetti test, and visual analog scale of vertigo), somatic, cognitive, and emotional status. Patients were randomized into two groups. The main group included patients who received betahistine 48 mg/day, Mexidol® 5.0 ml intravenously for 10 days, then 375 mg tablets/day for 50 days; the comparison group consisted of patients who used only betahistine 48 mg/day for 60 days. Treatment efficacy was assessed using a global scale on the 60th day of therapy in both groups, taking into account the opinion of the physician and the patient. Results. In elderly patients, dizziness was caused by several reasons in most cases (75%). In the combination treatment group (betahistine + Mexidol®), a more significant (more than twofold) reduction in dizziness symptoms was noted than in the comparison group. Conclusion. In elderly patients with chronic cerebrovascular disease and dizziness, combination therapy with Mexidol® and betahistine, which has neuroprotective properties, improves treatment outcomes.

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