Common dizziness drug class shows promise for treating vestibular migraine

by American Academy of Otolaryngology

edited by Gaby Clark, reviewed by Andrew Zinin

Gaby Clark

Scientific Editor

Meet our editorial team
Behind our editorial process

Andrew Zinin

Lead Editor

Meet our editorial team
Behind our editorial process Editors' notes

This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

trusted source

proofread

The GIST Add as preferred source

A new study finds that a class of oral and intranasal medications known as gepants may be an effective and well-tolerated treatment for vestibular migraine (VM). The findings are published in the journal Otolaryngology–Head and Neck Surgery.

Vestibular migraine is the most common cause of recurring spontaneous vertigo and can be profoundly disruptive to daily life, yet it remains underdiagnosed and undertreated. While many medications used for standard migraine headache are also prescribed for VM, options for stopping an acute vestibular attack remain limited. Clinical trials of triptans—among the most widely used abortive migraine medications—have not demonstrated effectiveness specifically for vestibular symptoms.

Gepants work by blocking calcitonin gene-related peptide (CGRP), a molecule known to drive migraine attacks. CGRP has also been identified throughout the central and peripheral vestibular system—the brain structures responsible for balance—providing a biological rationale for why blocking it may relieve dizziness and vertigo, not just head pain. Unlike injectable CGRP monoclonal antibodies, gepants can be taken as a pill or nasal spray, making them an accessible option for patients who are averse to injections.

"CGRP has emerged as a major factor in the pathogenesis of migraine. Our previous work showed in a randomized clinical trial that CGRP monoclonal antibodies were more effective than placebo in treating vestibular migraine. This current study looked at gepants in a retrospective fashion and found that a significant percentage of patients with vestibular migraine thought they were helpful. The next step is to follow up on these findings in a larger prospective study. In the meantime, we do think that it's reasonable to use gepants in the treatment of vestibular migraine," said Jeffrey D. Sharon, MD, corresponding author with the Department of Otolaryngology–Head & Neck Surgery at the University of California, San Francisco, and author of The Great Balancing Act, An Insider's Guide to the Human Vestibular System.

In this study, the most commonly used gepant was rimegepant (88.2% of patients), followed by ubrogepant (58.8%), atogepant (23.5%) and zavegepant (5.9%). Patients used gepants both to abort acute attacks and as daily preventive therapy. Those who used them for both purposes saw the highest benefit rates (100%), while abortive-only users reported benefit in 71.4% of cases. Most patients reported the onset of relief within hours and symptom improvement lasting approximately 24 hours. The majority of patients (76.5%) reported no side effects.

More information

Evan J. Patel et al, Early Experience Treating Vestibular Migraine With Small Molecule CGRP Antagonists, Otolaryngology–Head and Neck Surgery (2026). DOI: 10.1002/ohn.70196

Key medical concepts

Calcitonin Gene-Related PeptideRimegepant

Clinical categories

NeurologyClinical pharmacology Provided by American Academy of Otolaryngology Who's behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

Citation: Common dizziness drug class shows promise for treating vestibular migraine (2026, June 21) retrieved 21 June 2026 from https://medicalxpress.com/news/2026-06-common-dizziness-drug-class-vestibular.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.