Experiencia clínica con la combinación de cinarizina y dimenhidrinato en el tratamiento del vértigo de origen diverso en atención primaria: una serie de casos

Abstract

Introduction and objectives

Dizziness, including vertigo, imbalance, and presyncope, affects 15–20% of adults, increasing the risk of falls, especially in the elderly. The interaction between signals from the peripheral vestibular system, vestibular nuclei, and the central nervous system, modulated by neurotransmitters such as glutamate, acetylcholine, and glycine, along with histamine, adrenaline, and noradrenaline, is crucial for balance. Dizziness arises when vestibular information does not match other sources and can be associated with various neurological, psychiatric, respiratory, or infectious conditions. Current treatment is based on rest, particle replacement maneuvers and medications such as betahistine and sedatives, but the fixed combination of cinnarizine and dimenhydrinate has proven effective in clinical trials, effectively treating vertigo of various origins by acting on peripheral and central vestibular systems.

Patients

We present 7 clinical cases, in which we have used the same treatment with cinnarizine and dimenhydrate at fixed doses of 20/40 mg.

Results

The combination of cinnarizine and dimenhydrinate proved effective in managing a variety of vestibular disorders, including recurrent benign paroxysmal positional vertigo, vestibular migraine, Meniere's syndrome, and presbivestibulopathy. Patients experienced improvement in vestibular symptoms, such as dizziness, vertigo, and imbalance, proving to be a safe and effective drug, demonstrating in some cases the resolution of symptoms in patients previously treated with other therapies.

Conclusion

The versatility of the combination allows its use in the treatment of vertigo of various origins, making it a comprehensive and valuable option for situations where the precise diagnosis of the causes of vertigo is not clear.