Affiliations: [a]
Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| [b]
Department of Otorhinolaryngology Head and Neck Surgery, Osaka University Graduate School of Medicine, Yamadaoka, Suita City, Osaka, Japan
| [c]
Department of Otolaryngology, Nara Medical University, Shijocho, Kashihara City, Nara, Japan
| [d]
Department of Otolaryngology, Osaka General Medical Center, Mandai-higashi, Sumiyoshi-ku, Osaka City, Osaka, Japan
Correspondence:
[*]
Corresponding author: Arata Horii, Department of Otolaryngology Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-dori. Chuo-ku, Niigata City, Niigata 951-8510, Japan. Tel.: +81 25 227 2303; Fax: +81 25 227 0787; E-mail: ahorii@med.niigata-u.ac.jp.
Abstract: BACKGROUND: Psychiatric comorbidities are an important issue in the treatment of chronic dizziness patients. OBJECTIVE: To test the correlation between psychiatric status and subjective handicaps and to examine the effects of milnacipran on handicaps. METHODS: Hospital anxiety and depression scale (HADS) and handicaps were assessed by a questionnaire before and eight weeks after milnacipran treatment (50 mg/day) in 29 consecutive patients with chronic dizziness. Effects of milnaciplan were compared with fluvoxamine (200 mg/day). RESULTS: A significant correlation was found between anxious and depressive scale scores and also between HADS and handicaps. Duration of symptoms was longer in the anxious/depressive group (HADS≧13) than in the non-anxious/depressive group. Handicaps and HADS were significantly decreased after treatment only in the anxious/depressive group. There were no overall differences in drug effects between milnaciplan and fluvoxamine. However, the rate of patients with a post/pre ratio of handicaps <80% was higher in milnaciplan group compared with the fluvoxamine group. CONCLUSIONS: Not only anxiety disorders but also depression should be considered as comorbid psychiatric disorders in patients with chronic dizziness. Dizzy patients with psychiatric comorbidities have a longer duration of symptoms and more handicaps than those without psychiatric disorders. Milnacipran may be chosen as a treatment for patients with chronic dizziness with comorbid psychiatric disorders in case of and insufficient response to SSRIs.
