Abstract
ImportanceDizziness/vertigo is a common symptom that can lead to falls and reduced confidence in daily activities. It can result from vestibular, non-vestibular, or unidentified etiologies. Effective treatments with minimal side effects are essential to improving patient outcomes.ObjectiveTo compare the efficacy and safety of Ginkgo biloba extract EGb 761(®) with Betahistine in patients with dizziness/vertigo of unclear etiology.Study DesignRandomized, double-blind, controlled trial conducted from October 2022 to August 2023.SettingEar, Nose, and Throat Outpatient Department at Burapha Hospital.ParticipantsEighty-six individuals aged ≥20 with dizziness/vertigo lasting >1 month without a specific etiology.InterventionPatients were randomized to EGb 761(®) (120 mg/day) or Betahistine (36 mg/day) with matched placebos for 12 weeks, assessed at weeks 2, 6, and 12.Main Outcome MeasuresPrimary outcome: change in dizziness severity as assessed by the 11-Point Box Scale and Dizziness Handicap Inventory (DHI) scores. Secondary outcomes: safety.ResultsRepeated-measures ANOVA showed significant improvement over time in both groups (P < .001), with no group × time interaction, indicating comparable efficacy. For DHI, Betahistine showed a transient advantage at week 2 (P < .01, Cohen's d = 0.96), but no significant difference between treatments was observed at week 12. Both treatments were well tolerated, with only mild gastrointestinal side effects.ConclusionEGb 761(®) and Betahistine demonstrated comparable efficacy and good safety in treating dizziness or vertigo of unclear etiology. Clinical improvement was most evident within the first 2 weeks of therapy.RelevanceEGb 761(®) is a safe and effective alternative to Betahistine with comparable efficacy and good tolerability.