Effects of Antidepressants on Persistent Postural-Perceptual Dizziness (PPPD)

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  • Yagi Chihiro
    Department of Otolaryngology, Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Morita Yuka
    Department of Otolaryngology, Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Kitazawa Meiko
    Department of Otolaryngology, Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Yamagishi Tatsuya
    Department of Otolaryngology, Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Ohshima Shinsuke
    Department of Otolaryngology, Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Izumi Shuji
    Department of Otolaryngology, Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Takahashi Kuniyuki
    Department of Otolaryngology, Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences
  • Horii Arata
    Department of Otolaryngology, Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences

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Other Title
  • 持続性知覚性姿勢誘発めまい (Persistent Postural-Perceptual Dizziness: PPPD) に対する抗うつ薬の効果について
  • ジゾクセイ チカクセイ シセイ ユウハツメマイ(Persistent Postural-Perceptual Dizziness : PPPD)ニ タイスル コウウツヤク ノ コウカ ニ ツイテ

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<p>　The diagnostic criteria for Persistent Postural-Perceptual Dizziness (PPPD) was defined by the Committee for the Classification of Vestibular Disorders of the Barany Society, and published in the Journal of Vestibular Research in 2017. PPPD is characterized by chronic vestibular syndrome persisting for >3 months, that is typically preceded by acute vestibular disorders. Antidepressant medication, vestibular rehabilitation, and cognitive behavioral therapy have been reported to be useful for the treatment of PPPD. In this study, we evaluated the efficacy of pharmacotherapy with antidepressants in 90 patients diagnosed as having PPPD. A selective serotonin reuptake inhibitor (SSRI)(escitalopram, 10-20mg/day), serotonin and noradrenaline reuptake inhibitor (SNRI)(venlafaxine, 75mg/day), and noradrenergic and specific serotonergic antidepressant (NaSSA)(mirtazapine, 15mg/day) were used in this study. Antidepressant therapy led to improvement of the Dizziness Handicap Inventory (DHI) score, suggesting that it was effective for reducing the dizziness in patients with PPPD. On the other hand, in the non-treated group, consisting of patients who, for some reason, could not receive medication, there was no significant improvement in dizziness during the approximately 1-year follow-up period, suggesting the usefulness of therapeutic intervention for PPPD. While antidepressant drug therapy was shown to be effective, the incidence of adverse effects was high for all the drug classes, and the treatment continuation rate tended to decrease as the incidence of adverse effects increased, suggesting that appropriate control of adverse effects is important to achieve better treatment efficacy.</p>

Journal

  • Nippon Jibiinkoka Gakkai Kaiho

    Nippon Jibiinkoka Gakkai Kaiho 124 (7), 998-1004, 2021-07-20

    Japanese Society of Otorhinolaryngology-Head and neck surgery

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