What is the role of Beta-histidine (Histidine) for treating ataxia?

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Last updated: March 23, 2025View editorial policy

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From the Guidelines

Betahistine is not recommended as a primary treatment for ataxia, as its effectiveness is primarily established for vestibular disorders like Ménière's disease, not for addressing the neurological mechanisms of ataxia. While betahistine has been shown to reduce vertigo in patients with Ménière's disease, with a reported 56% reduction in vertigo when taking betahistine compared to placebo 1, its role in treating ataxia is not well-established. Ataxia involves problems with coordination and balance, and treatment typically requires addressing the underlying cause.

For patients with hereditary ataxias, there are currently no FDA-approved medications that reverse the condition, and management usually focuses on supportive care, including:

  • Physical therapy
  • Occupational therapy
  • Speech therapy Betahistine works by improving blood flow in the inner ear and modulating histamine activity, which may help with vertigo symptoms but does not address the neurological mechanisms of most ataxias. If a patient has ataxia with a significant vestibular component, betahistine might provide some symptomatic relief for dizziness, but it should not be considered a treatment for the underlying ataxia itself. Patients with ataxia should be evaluated by a neurologist to determine the specific cause and appropriate management strategy, as indicated by the clinical practice guideline for Ménière's disease 1.

From the Research

Role of Beta-histidine (Histidine) in Treating Ataxia

There are no research papers to assist in answering this question, as the provided studies focus on the use of betahistine in treating vertigo and vestibular disorders, rather than ataxia.

Related Information on Betahistine

  • Betahistine is used to treat vertigo and vestibular disorders, such as Meniere's disease and benign paroxysmal positional vertigo (BPPV) 2, 3, 4, 5.
  • The drug works by improving blood flow to the inner ear and has a positive effect on reducing vertigo symptoms 2.
  • Betahistine is generally well-tolerated with a low risk of adverse events 2, 4.
  • The efficacy of betahistine in treating central vestibular disorders, such as ataxia, is not well-studied and requires further investigation 5.

Key Findings on Betahistine

  • Betahistine has been shown to be effective in reducing vertigo symptoms in patients with Meniere's disease and other vestibular disorders 2, 3, 4, 5.
  • The optimal dosage of betahistine for treating vertigo is 48 mg daily for 3 months 4, 5.
  • Betahistine has an excellent safety profile with a low risk of adverse events 2, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Betahistine for symptoms of vertigo.

The Cochrane database of systematic reviews, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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