Diphenhydramine, Sodium Bicarbonate, or Combination for Acute Peripheral Vertigo

Does intravenous sodium bicarbonate alone or with diphenhydramine provide better symptom relief than diphenhydramine alone for adults with acute peripheral vertigo?In this randomized clinical trial of 225 patients, combination therapy with diphenhydramine and sodium bicarbonate produced greater improvement in vertigo severity at 60 minutes and reduced the need for rescue medication compared with diphenhydramine alone. Sedation occurred more often with diphenhydramine, whereas sodium bicarbonate caused more injection discomfort.This study suggests that combination therapy with diphenhydramine and sodium bicarbonate may offer more effective relief of acute peripheral vertigo symptoms than diphenhydramine alone and could reduce the need for additional treatment.

Corresponding Authors: Wen-Chu Chiang, MD, PhD, Department of Emergency Medicine, National Taiwan University Hospital Yunlin Branch, No. 579, Sec. 2, Yunlin Rd., Douliu City, Yunlin County 640, Taiwan (drchiang.tw@gmail.com); Chien-Hua Huang, MD, PhD, Department of Emergency Medicine, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei 100, Taiwan (chhuang5940@ntu.edu.tw).

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