The effectiveness of piracetam in vertigo.

Vertigo is a sensation of altered orientation in space and may be defined as an illusion of movement. It is a subjective symptom and therefore difficult to assess. Examination and diagnosis remain difficult. Although treatment should be directed at the underlying cause or disorder, the origin of vertigo is frequently unknown or untreatable. Pharmacotherapy is required for symptomatic treatment. Piracetam has been shown to be effective in vertigo of both central and peripheral origin. It is thought to act on vestibular and oculomotor nuclei in the brain stem and thus on the central control of balance enhancing mechanisms of compensation and habituation. This review of double-blind trials shows that piracetam alleviates vertigo after head injury, vertigo of central origin as, for example, in vertebrobasilar insufficiency and in peripheral vestibular disorders, especially in middle-aged and elderly subjects. Piracetam decreases the frequency but probably not the severity of exacerbations in patients with chronic or recurrent vertigo. The usual dosage of piracetam in vertigo is 2.4-4.8 g daily. Tolerability of piracetam is good and adverse effects have been mild and infrequent.