flunarizine and Labyrinth-Diseases

Experience with flunarizine, a selective calcium-entry blocker, in the treatment of dizziness is reviewed. Clinical efficacy was predicted in pharmacological studies both in rabbits and humans: torsion swing or caloric induced nystagmus were significantly suppressed by flunarizine. Open therapeutic findings, using clinical and electronystagmographic or audiographic assessments as well, showed that flunarizine is of benefit to patients with vertigo of labyrinthine as well as of cerebrovascular origin. These results were confirmed in double-blind controlled trials. Flunarizine, either started with a loading dose gradually decreased thereafter, or given at a fixed 10 mg. dose schedule was proven to produce rapid improvement of dizziness and unsteadiness and to be tolerated very well.

Topics: Animals; Calcium Channel Blockers; Cerebrovascular Disorders; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Flunarizine; Humans; Labyrinth Diseases; Piperazines; Rabbits; Vertebrobasilar Insufficiency; Vertigo

A total of 908 patients with peripheral vestibular disorders were treated with calcium antagonists for periods of 10 to 120 days in a series of controlled clinical trials using a placebo or other medication for comparison. The cumulative analysis of the results indicates that cinnarizine, flunarizine and bencyclan have produced good clinical results, particularly in patients with vascular problems. A comparison between different doses used in different trials revealed a correlation of good clinical results to smaller doses of some of these medications.

Topics: Bencyclane; Calcium Channel Blockers; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Flunarizine; Humans; Labyrinth Diseases; Vestibule, Labyrinth

Experience with flunarizine, a selective calcium-entry blocker, in the treatment of dizziness is reviewed. Clinical efficacy was predicted in pharmacological studies both in rabbits and humans: torsion swing or caloric induced nystagmus were significantly suppressed by flunarizine. Open therapeutic findings, using clinical and electronystagmographic or audiographic assessments as well, showed that flunarizine is of benefit to patients with vertigo of labyrinthine as well as of cerebrovascular origin. These results were confirmed in double-blind controlled trials. Flunarizine, either started with a loading dose gradually decreased thereafter, or given at a fixed 10 mg. dose schedule was proven to produce rapid improvement of dizziness and unsteadiness and to be tolerated very well.

Topics: Animals; Calcium Channel Blockers; Cerebrovascular Disorders; Cinnarizine; Clinical Trials as Topic; Double-Blind Method; Flunarizine; Humans; Labyrinth Diseases; Piperazines; Rabbits; Vertebrobasilar Insufficiency; Vertigo

The effects of the "vestibular sedative" drug Flunarizine upon the oculomotor functions of pursuit and voluntary saccades and upon the vestibular response (to rotational stimuli) were assessed in twenty volunteer subjects. The study was then extended to three patients with chronic imbalance of central origin who had reported a beneficial symptomatic response to the drug. Three of the volunteer subjects were found to have a directional preponderance (presumed to arise from peripheral dysfunction). In the remaining seventeen normal subjects Flunarizine was found to reduce the amplitudes of fast phases of vestibular nystagmus. The directional preponderance in the other three subjects was redressed through production of fast phases which were of lower and more uniform amplitude. In the patients, in addition to a reduction in fast phase amplitude, there was a reduction or abolition of after nystagmus. In no case was any reduction in slow phase velocity observed. Pursuit and voluntary saccades were unaffected by the drug. It was concluded, on the basis that the fast phases of nystagmus are centrally generated, that Flunarizine has a central action rather than a depressant effect upon the vestibular end organ. In view of known oculomotor physiology and pharmacology it is proposed that vestibular sedatives act by depression of Type II vestibular neurons, and modification of the functional relationships between the vestibular nuclei, the perihypoglossal nuclei and the flocculus of the cerebellum. A trial of vestibular active drug is indicated particularly in patients in whom asymmetry of the vestibular response and/or abnormal after nystagmus is demonstrated.

Topics: Adult; Brain Stem; Cerebellum; Cinnarizine; Double-Blind Method; Electrooculography; Eye Movements; Female; Flunarizine; Humans; Labyrinth Diseases; Male; Middle Aged; Piperazines; Vestibule, Labyrinth