A prospective trial of sertraline for chronic subjective dizziness

Jeffrey P Staab, Michael J. Ruckenstein, Jay D. Amsterdam

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Objectives/Hypothesis: The authors previously reported that selective serotonin reuptake inhibitors (SSRIs) reduce chronic subjective dizziness in patients with and without psychiatric illnesses. To extend those preliminary findings and test the hypothesis that SSRIs may offer a novel treatment for chronic subjective dizziness, the authors conducted a prospective study of sertraline in patients with dizziness for more than 6 months, in the absence of active physical neurotologic illness. Study Design: Sixteen-week, prospective, open-label, flexible-dose clinical trial. Methods: Twenty-four patients with subjective dizziness for more than 6 months and no active physical neurotologic illness were studied. Eighteen patients had major anxiety disorders. Six had minor frustration or worry that did not warrant a psychiatric diagnosis. Sertraline was administered at a daily dose of 25 mg, which was increased to a maximum daily dose of 200 mg. Dizziness, functional impairment, and psychological distress were measured using the Dizziness Handicap Inventory (DHI) and Brief Symptom Inventory-53 (BSI-53). Treatment outcomes were analyzed using repeated-measures multivariate analyses of variance, with last observations carried forward. Results: Three patients were excluded from data analysis for disqualifying medical conditions, one for protocol violations. Fifteen (75%) patients completed treatment. Five (25%) withdrew for adverse effects or lack of efficacy. The median daily dose of sertraline was 100 mg. Sertraline significantly reduced scores on all three DHI subscales and the BSI-53. Eleven of 15 (73%) patients who completed treatment had a positive response, including 8 of 11 (73%) with major anxiety disorders and 3 of 4 (75%) with no psychopathological conditions. Six patients enjoyed a full remission of symptoms. Conclusion: Sertraline significantly reduced chronic subjective dizziness in patients without active physical neurotologic illness, including those with and without psychiatric comorbidity.

Original languageEnglish (US)
Pages (from-to)1637-1641
Number of pages5
JournalLaryngoscope
Volume114
Issue number9 I
DOIs
StatePublished - Sep 2004
Externally publishedYes

Fingerprint

Sertraline
Dizziness
Equipment and Supplies
Serotonin Uptake Inhibitors
Anxiety Disorders
Psychiatry
Frustration
Mental Disorders
Comorbidity
Analysis of Variance
Therapeutics
Multivariate Analysis
Clinical Trials
Prospective Studies
Psychology

Keywords

  • Dizziness
  • Psychiatric disorder
  • Serotonin
  • Serotonin uptake inhibitor
  • Sertraline

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

A prospective trial of sertraline for chronic subjective dizziness. / Staab, Jeffrey P; Ruckenstein, Michael J.; Amsterdam, Jay D.

In: Laryngoscope, Vol. 114, No. 9 I, 09.2004, p. 1637-1641.

Research output: Contribution to journalArticle

Staab, Jeffrey P ; Ruckenstein, Michael J. ; Amsterdam, Jay D. / A prospective trial of sertraline for chronic subjective dizziness. In: Laryngoscope. 2004 ; Vol. 114, No. 9 I. pp. 1637-1641.
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abstract = "Objectives/Hypothesis: The authors previously reported that selective serotonin reuptake inhibitors (SSRIs) reduce chronic subjective dizziness in patients with and without psychiatric illnesses. To extend those preliminary findings and test the hypothesis that SSRIs may offer a novel treatment for chronic subjective dizziness, the authors conducted a prospective study of sertraline in patients with dizziness for more than 6 months, in the absence of active physical neurotologic illness. Study Design: Sixteen-week, prospective, open-label, flexible-dose clinical trial. Methods: Twenty-four patients with subjective dizziness for more than 6 months and no active physical neurotologic illness were studied. Eighteen patients had major anxiety disorders. Six had minor frustration or worry that did not warrant a psychiatric diagnosis. Sertraline was administered at a daily dose of 25 mg, which was increased to a maximum daily dose of 200 mg. Dizziness, functional impairment, and psychological distress were measured using the Dizziness Handicap Inventory (DHI) and Brief Symptom Inventory-53 (BSI-53). Treatment outcomes were analyzed using repeated-measures multivariate analyses of variance, with last observations carried forward. Results: Three patients were excluded from data analysis for disqualifying medical conditions, one for protocol violations. Fifteen (75{\%}) patients completed treatment. Five (25{\%}) withdrew for adverse effects or lack of efficacy. The median daily dose of sertraline was 100 mg. Sertraline significantly reduced scores on all three DHI subscales and the BSI-53. Eleven of 15 (73{\%}) patients who completed treatment had a positive response, including 8 of 11 (73{\%}) with major anxiety disorders and 3 of 4 (75{\%}) with no psychopathological conditions. Six patients enjoyed a full remission of symptoms. Conclusion: Sertraline significantly reduced chronic subjective dizziness in patients without active physical neurotologic illness, including those with and without psychiatric comorbidity.",
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