Calcium Entry Blockers in the Treatment of Vertigo

Few calcium entry blockers have been studied in the treatment of vertigo. Flunarizine and cinnarizine are the most extensively studied substances. They have been shown to be valuable drugs in the therapeutic approach to vertigo. A few pilot studies have been performed with nimodipine but controlled data are lacking. Flunarizine has a direct long-lasting vestibulodepressant effect in both animals and humans. In patients with labyrinthine vertigo, it produced a marked symptomatic relief of symptoms significantly exceeding the effects of placebo or nicergoline. A number of studies dealing with vertigo of central etiology were also positive. Patient selection in such trials, however, is doomed to be less precise so that cautiousness must be exerted in interpreting such studies. The level of proof for flunarizine is still as good as for other substances or better. It is discussed whether the effects are due to calcium entry blocking properties.