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Picrotoxin for vertigo control in Ménière’s disease and other peripheral vestibular disorders: a systematic review

Published online by Cambridge University Press:  14 July 2025

Stefan Lyutenski Open the ORCID record for Stefan Lyutenski [Opens in a new window] ,
Paul James  and
Marc Bloching
Stefan Lyutenski*
Affiliation:
Department of Otorhinolaryngology, Helios Hospital Berlin-Buch, Berlin, Germany
Paul James
Affiliation:
Department of Otorhinolaryngology, Helios Hospital Berlin-Buch, Berlin, Germany
Marc Bloching
Affiliation:
Department of Otorhinolaryngology, Helios Hospital Berlin-Buch, Berlin, Germany
*
Corresponding author: Stefan Lyutenski; Email: s_lyutenski@gmx.de
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Abstract

Objectives

The aim of this study is to systematically review and analyse the literature regarding clinical application of picrotoxin for vertigo caused by peripheral vestibular disorders.

Methods

We conducted a search in PubMed/MEDLINE and Google Scholar in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses recommendations. The primary selection included all studies exploring the effect of this phytopharmacological substance on the vestibular system and vertigo. The secondary selection included only reports on its clinical use for treatment of Ménière’s disease and other peripheral vestibular disorders.

Results

From the 398 identified studies, 18 were included from the primary selection and 6 from the secondary selection. In total, 203 patients received picrotoxin; 85 of them were treated for vertigo with 1-mg picrotoxin suppositories. In this subgroup vertigo was reduced in 74.9 per cent.

Conclusion

Picrotoxin is a non-invasive treatment option worth considering, especially in cochlear-implanted patients with recurring disabling vertigo.

Keywords

picrotoxinMénière’s diseasevertigovestibular diseasesvestibular system

Information

Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 139 , Issue 11 , November 2025 , pp. 1021 - 1027
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Stefan Lyutenski takes responsibility for the integrity of the content of the paper

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