Homeopathic Remedy for Vertigo
December 1, 1998 3 minutes read
Homeopathic Remedy for Vertigo
December 1998; Volume 1: 143
Source: Weiser M, et al. Homeopathic vs. conventional treatment of vertigo: a randomized double-blind controlled clinical study. Arch Otolaryngol Head Neck Surg 1998; 124:879-885.
To compare the efficacy and safety of a homeopathic remedy against betahistine hydrochloride (active control) in the treatment of patients with vertigo of various origins in a confirmative equivalence trial, we randomized a total of 119 patients from 15 general practice study centers.
Both homeopathic and conventional treatments showed a clinically relevant reduction in the mean frequency, duration and intensity of the vertigo attacks. The therapeutic equivalence of the homeopathic remedy and betahistine was established statistically. Both remedies reduced the frequency, duration and intensity of vertigo attacks during a 6-week treatment period. Also, vertigo-specific complaints were significantly reduced in both treatment groups.
Comment
Fortunately, peripheral vertigo is usually self-limited. Unfortunately, physicians usually have little to offer beyond antihistamines and antiemetics.
These German investigators at a contract research organization recruited, randomized, treated, and observed patients with acute or chronic (>6 months) vertigo who had at least three attacks the week before the study. They used identically tasting and looking liquid placebos 15 gtt tid plus either the homeopathic remedy or betahistine (18 mg/d) for 42 days. They measured quality of life using the validated Medical Outcome Study-Short Form 36, and self-reported frequency, duration, and intensity of vertigo. The subjects were assessed on days 1, 3, 7, 14, 28, and 42.
The authors state that betahistine (2-pyridine) stimulates H1 and H2 cerebral receptors, resulting in vasodilation, and that it is (in Germany) the current treatment of choice for vertigo. Meclizine HCl is often given in the United States for the same indication. The homeopathic preparation tested included ambra grisea DE6, anamirta cocculus D4, conium maculatum D3, and petroleum rectificatum D8.
Data on 105 patients were analyzed: 29 men and 76 women, mean age early 50s, 23% with abnormal findings, half with vestibular vertigo or vasomotor vertigo, and half with unknown diagnoses. Most (70%) in both treatment groups were being treated for the first time, with symptoms generally less than two months.
Both preparations reduced direct vertigo symptoms, intensity of vertigo during exercises, and vertigo-associated symptoms. Frequency of attacks fell to barely once daily from 4-6 times daily; duration of attacks was halved; intensity was cut by 2/3. No significant differences in physical or mental health or tolerability of the agents were observed between the treatment groups.
Problems with this trial include lack of a real placebo control (adding a placebo to each of the two interventional arms is curious, though the authors claim it would be unethical not to offer one of the two treatments given); uncertain etiology of vertigo; an uncertain rate of spontaneous, unrelated improvement; and the relationship of the demonstrated improvement to the person-to-person contact offered six times in six weeks. No mechanism was postulated for the effectiveness of the homeopathic remedy.
Recommendation
Taking this homeopathic preparation—or any homeopathic preparation—is unlikely to do serious harm. But proof of the ability to diminish symptoms that can be expected to fade awaits a better and placebo-controlled trial.
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