Neuropharmacology of Vestibular System Disorders

TLDR

Recent advances in ionic channel function and synaptic transmission have led to new models for understanding vestibular dysfunction and its management. The review aims to examine the neuropharmacology of the vestibular system, focusing on drug mechanisms of action and their potential to illuminate vestibular disease pathophysiology. Drugs are categorized by their primary mechanisms—neurotransmitter/neuromodulator receptor modulation or voltage‑gated ion channel effects—and their pharmacology is critically reviewed. Keywords: inner ear, vertigo, dizziness, Meniere's disease, vestibular nuclei, hair cells, excitatory amino acids.

Abstract

This work reviews the neuropharmacology of the vestibular system, with an emphasis on the mechanism of action of drugs used in the treatment of vestibular disorders. Otolaryngologists are confronted with a rapidly changing field in which advances in the knowledge of ionic channel function and synaptic transmission mechanisms have led to the development of new scientific models for the understanding of vestibular dysfunction and its management. In particular, there have been recent advances in our knowledge of the fundamental mechanisms of vestibular system function and drug mechanisms of action. In this work, drugs acting on vestibular system have been grouped into two main categories according to their primary mechanisms of action: those with effects on neurotransmitters and neuromodulator receptors and those that act on voltage-gated ion channels. Particular attention is given in this review to drugs that may provide additional insight into the pathophysiology of vestibular diseases. A critical review of the pharmacology and highlights of the major advances are discussed in each case. Keywords: Inner ear, Vertigo, Dizziness, Meniere's disease, vestibular nuclei, hair cells, excitatory amino acids