Ondansetron or promethazine: Which one is better for the treatment of acute peripheral vertigo?

Publication date: Available online 14 September 2018

Source: American Journal of Otolaryngology

Author(s): Alia Saberi, Seyed Hashem Pourshafie, Ehsan Kazemnejad-Leili, Shadman Nemati, Sara Sutohian, Sara Sayad Fathi

Abstract

Background

Vertigo is a common annoying complaint needing emergent treatment. There are various treatment options for this condition with different outcomes and side effects.

Objectives

Assessment and comparison of the effectiveness of Ondansetron and Promethazine in the treatment of acute peripheral vertigo.

Materials and methods

This clinical trial was conducted in an academic hospital in the north of Iran in 2017. A total of 170 eligible patients were randomly allocated to groups A: received intramuscular (IM) promethazine; and B: received intravenous (IV) Ondansetron, using quadripartite blocks. The severity of vertigo, nausea, blood pressure, heart rate, side-effects, need for re-administration, and the time to become asymptomatic were assessed before the injections, 30 min after and 2 h after the injections.

Results

Excellent improvement in vertigo occurred in both groups (P < 0.001), with a more significant reduction in the promethazine-treated group (P < 0.001). Nausea was reduced more significantly in the ondansetron-treated group (P < 0.05). There were more side-effects seen in the promethazine-treated when compared to the group with ondansetron treatment (P < 0.001). No significant differences were seen in the blood pressures between groups (P > 0.05). Heart rates were reduced in both groups but the changes were insignificant (P > 0.05). The ondansetron-treated group showed a greater need for re-administration of the medication (50.6% vs. 27.1%). The relief score was significantly higher in the ondansetron-treated group compared with the group received promethazine (P < 0.001). The time to become asymptomatic showed no statistically significant difference between groups (p = 0.28).

Conclusion

Our results indicated that while promethazine cures peripheral vertigo more efficiently, ondansetron is more beneficial for the improvement of nausea and vomiting.

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