Comparative study of anti-vertiginous and anti-anxious drugs for the treatment of chronic vestibular patients with secondary anxiety

Abstract

Background: Regarding the relationship between psychiatric disorders and dizziness, anxiety is the most frequently seen psychiatric disorder in dizzy patients.

Objective: We compared the effects of anti-anxious benzodiazepines (loflazepate) and anti-vertiginous cholinergic antagonist (diphenidol) on the subjective symptoms in chronic vestibular patients with secondary anxiety.

Methods: Forty-three patients who had chronic dizziness lasting more than three months due to organic vestibular diseases with secondary anxiety. Anxiety was evaluated by the State-Trait Anxiety Inventory (STAI). Subjective handicaps due to dizziness were assessed by the validated questionnaire consisted of 14 questions that were categorized into two physical and three emotional factors. During the initial six months of the study, 21 patients were treated by anti-anxious benzodiazepines (loflazepate, 2 mg/day) for four weeks, whereas anti-vertiginous cholinergic antagonist (diphenidol, 75 mg/day) was used for four weeks for other 22 patients during the later six months-period. Subjective handicaps and STAI were compared between pre- and post-treatment.

Results: Loflazepate improved not only three emotional factors and state anxiety but also one of the physical factors. Diphenidol improved two physical factors but no emotional factors nor state and trait anxiety.

Conclusions: Targeting for comorbid anxiety was beneficial for subjective symptoms of chronic dizziness with secondary anxiety.

Chinese abstract

背景：关于精神障碍与头晕的关系, 焦虑是头晕患者最常见的精神障碍。

目的：比较抗焦虑苯二氮卓类（loflazepate）和抗眩晕胆碱能拮抗剂（diphenidol）对慢性前庭继发性焦虑患者主观症状的影响。

方法：四十三例因器质性前庭疾病伴继发性焦虑而持续3个月以上的慢性眩晕患者。采用状态-特质焦虑量表（STAI）对焦虑进行评估。采用经验证的14个问题组成的问卷, 将这14个问题分为两个生理因素和三个情感因素, 对头晕引起的主观障碍进行评估。在该研究的最初五个月内, 21名患者接受抗焦虑苯二氮卓类药物治疗（loflazepate , 2 毫克/天）, 持续4周；而其余22名患者在后五个月内接受抗眩晕胆碱能拮抗剂（diphenidol, 75 毫克/天）, 持续4周。比较治疗前后的主观障碍和STAI。

结果：使用loflazepate不仅改善了三种情绪因素和状态焦虑, 而且改善了一种生理因素。diphenidol改善了两种生理因素, 但没有改善情绪因素, 也没有改善状态和特质焦虑。

结论：以共病焦虑为目标, 有助于继发性焦虑的慢性眩晕的主观症状。

Keywords:

• Chronic dizziness
• secondary anxiety
• benzodiazepines
• laflazepate
• diphenidol
• state trait anxiety inventory
• subjective handicaps

Disclosure statement

No potential conflict of interest was reported by the authors.