Ondansetron or promethazine: Which one is better for the treatment of acute peripheral vertigo?

Abstract Background Vertigo is a common annoying complaint needing emergent treatment. There are various treatment options for this condition with different outcomes and side effects. Objectives Assessment and comparison of the effectiveness of Ondansetron and Promethazine in the treatment of acute peripheral vertigo. Materials and methods This clinical trial was conducted in an academic hospital in the north of Iran in 2017. A total of 170 eligible patients were randomly allocated to groups A: received intramuscular (IM) promethazine; and B: received intravenous (IV) Ondansetron, using quadripartite blocks. The severity of vertigo, nausea, blood pressure, heart rate, side-effects, need for re-administration, and the time to become asymptomatic were assessed before the injections, 30 min after and 2 h after the injections. Results Excellent improvement in vertigo occurred in both groups ( P P P  > 0.05). Heart rates were reduced in both groups but the changes were insignificant (P > 0.05). The ondansetron-treated group showed a greater need for re-administration of the medication (50.6% vs. 27.1%). The relief score was significantly higher in the ondansetron-treated group compared with the group received promethazine ( P p  = 0.28). Conclusion Our results indicated that while promethazine cures peripheral vertigo more efficiently, ondansetron is more beneficial for the improvement of nausea and vomiting.