Valentine Guinness has suffered with bouts of chronic dizziness and motion-sickness since childhood. But around a decade ago, the 66-year-old writer and musician’s spells ramped up in severity, with the simplest tasks leaving him overcome with extreme nausea.
‘It got to the stage where I’d get dizzy and nauseous just standing chopping vegetables or looking down at my phone,’ says Valentine, from west London.
‘And sometimes it wouldn’t wear off – it just stayed with me all day.’
Unable to shift the episodes, his NHS GP referred him to an ear specialist. But despite an MRI scan and other tests, doctors were unable to pinpoint the cause of Valentine’s vertigo. Nor were they able to offer him any treatment.
Then, three years ago, while visiting a private GP about an unrelated issue, he mentioned his dizzy spells and the doctor offered him a potential solution: A 5p tablet called betahistine.
‘He told me that while betahistine didn’t always help, it did seem to work in some people,’ says Valentine. He began taking four 16mg tablets every day and says the change was near-instantaneous.
‘After a few days, it dawned on me I’d not had one attack of vertigo,’ he says. ‘It was miraculous. It was so effective the GP said I could safely drop down to one pill a day and I’ve not had a single bout of vertigo, dizziness or nausea since.’
Valentine adds: ‘My NHS doctor never even mentioned betahistine to me.’
Valentine Guinness, pictured with his fashion designer wife, Lulu, has suffered with bouts of chronic dizziness and motion-sickness since childhood
Experts say there are potentially thousands of patients who, like Valentine, stand to benefit from betahistine but have not been offered it by their NHS GP.
So what is betahistine – and can it really help patients with never-ending dizziness?
First, it’s important to understand what is vertigo. More than two million people in the UK live with chronic dizziness that has continued for months or even years. However, there are many causes.
Often milder forms of the problem, such as unsteadiness or light-headedness, are triggered by low blood pressure, dehydration, anxiety or certain medicines.
It can be difficult to find the cause of more intense dizziness – known as vertigo, where you get the sensation that the room is spinning or tilting.
One cause is labyrinthitis, which is an inner ear infection. This usually lasts just a few weeks. In rare cases, it can be a sign of a stroke or cancer.
A particularly common cause of chronic vertigo is called benign paroxysmal positional vertigo, or BPPV. It occurs when tiny crystals in the inner ear, partly responsible for balance, become dislodged.
Betahistine can be prescribed to patients with chronic dizziness that has no clear cause
Finally, a rarer vertigo trigger is a condition called Meniere’s disease. This occurs due to fluid build-up and affects only one in 1,000 people but can have a devastating impact on quality of life.
The tablet betahistine was first approved in the early 1970s for the treatment of Meniere’s disease – making it one of the only available treatments for the condition.
It also can be prescribed to patients with chronic dizziness that has no clear cause. Betahistine is thought to fight dizziness by bolstering blood flow to the inner ear, which removes excess fluid.
However, in recent years, the drug has fallen out of favour due to reports that it is ineffective.
‘Most evidence shows it doesn’t work,’ says Professor Tony Narula, a leading Harley Street ear, nose and throat specialist.
But not all specialists agree. Dr Dean Eggitt, a Doncaster-based GP, prescribes betahistine both to patients with suspected Meniere’s disease and also BPPV. However, he says it is not right for everyone.
‘It has to be used appropriately or it could mask serious underlying problems,’ he says. ‘It’s very useful for short-term relief of vertigo, often just for three to five days.’
Dr Eggitt adds that, in particular, betahistine can be useful for treating BPPV.
Studies show the most effective BPPV treatment is a five-minute exercise routine, called the Epley Manoeuvre. It involves tilting the head through a series of movements to get the crystals back to where they should be. This is usually done under the supervision of a physiotherapist or GP.
However, Dr Eggitt says many patients may benefit from taking betahistine while doing this because the exercises can temporarily make them feel nauseous or even worsen the dizziness. In fact, a US study, published in the medical journal Medicine in 2023, found that combining betahistine with the Epley Manoeuvre was significantly more effective at reducing dizziness than the head movements alone.
Valentine Guinness says: ‘I do think it should perhaps be more widely available.’