Comparison between the effectiveness of three prophylactic drugs for vestibular migraine; cinnarizine, propranolol, and topiramate: prospective study

Abstract

Abstract Background Vestibular migraine (VM) is considered one of the most common causes of episodic vertigo. Acute attacks may interfere or hinder daily activities, and hence decrease the quality of life. Accordingly, this study was designed to evaluate and compare the effectiveness of Cinnarizine, Propranolol, and Topiramate as prophylactic treatment for vestibular migraine, in order to decrease the occurrence of acute attacks. Several medications have been proposed as a prophylactic treatment, but their benefit is still a vast field of study. Methods Forty-five subjects were diagnosed with vestibular migraine. They were divided into 3 groups; each group either received Cinnarzine, Propranolol, or Topiramate. All patients were submitted to thorough history taking for headache and vertiginous attacks, Dizziness Handicap Inventory questionnaire (DHI) -Arabic version, visual analog scale , videonystagmography, and computerized dynamic posturography (CDP) before and after receiving the treatment by 3 months. Results Topiramate was significantly superior in reducing the frequency and severity of headache attacks. The three drugs showed improvement but with no significant difference as regards duration and frequency of vertiginous attacks, DHI scores, and CDP. Only 5 patients had non-serious temporary side effects. Conclusions The three drugs were effective for ameliorating vertiginous attacks in vestibular migraine patients, but Topiramate was better in the 25 mg twice daily dose.