Introduction Dizziness is a term used by patients to describe various sensations such as lightheadedness, imbalance, illusory feelings of movement and disorientation (Murdin et al., 2013). Vertigo is the subtype of dizziness, defined as an illusory sensation of motion of either the self or the surroundings in the absence of true motion (Bhattacharyya et al., 2017). Vertigo is a symptom not a diagnosis. There are many disorder or disease with vertigo as the main symptom. Table 1 summarized the differential diagnosis of vertigo. The origin of vertigo may involve some anatomy structures. The maintenance of the sense of balance and spatial orientation depends on input from the vestibular labyrinth, visual system, and proprioceptive nerves arising from tendons, muscles, and joints. The vestibular nuclei, which are in the medulla and lower pons, receive input from the vestibular labyrinth via the vestibular branch of cranial nerve VIII and from the cerebellum. The vestibular nuclei, in turn, send efferent fibres to the cerebellum, the medial longitudinal fasciculus, and the vestibulospinal tract (Mehndiratta Kumar, 2010). Thus, and the etiology of vertigo may arise from inner ear, brainstem, cerebellum, or may be of psychic origin(Strupp et al., 2013) and can be defined as peripheral vertigo and central vertigo based on the involved anatomy structure. Another differential diagnosis of peripheral vertigo, based on REVERT Registry, is peripheral vestibular vertigo of unknown origin or pathophysiology (PVVP). From total 4294 subjects, at least 832 subjects considered as PVVP (Agus et al. 2013) Additional differential diagnosis of . central vertigo i.e.: vestibullar migraine (Rea, 2010), stroke, transient ischemic attack (Gnerre et al., 2015), and vertebrobasilar ischemia (Li et al., 2011). Vertigo may also triggered by psychiatric disorder, such as anxiety disorder (Kerber Baloh, 2011). and Vertigo impair patients' health-related quality of life (QoL) (Duracinsky et al., 2007). Vertigo are common in the general population with lifetime prevalences of about 7 % (Lempert Neuhauser, 2009). Based on a neurotologic and survey of the general population, 1 year vertigo prevalence 4.9% (Neuhauser Hannelore, 2007). Based on a and Betahistine as a treatment for vertigo: A systematic review of randomized controlled trial Rizaldy Taslim Pinzon , Rosa De Lima Renita Sanyasi 1 2 1 Faculty of Medicine Duta Wacana Christian University, Yogyakarta , , Indonesia, 55224 2 Internship Doctor at dr. Efram Harsana Air Force Hospital, Magetan, East Java, Indonesia, 63392 * Corresponding Author: Address for Rizaldy Taslim Pinzon, MD, PhD Faculty of Medicine Duta Wacana Christian University, Yogyakarta , , Indonesia, 55224 Email: drpinzon17@gmail.com Abstract Background: Vertigo is the subtype of dizziness and impair patients' health-related quality of life. Betahistine is generally well-tolerated as an anti-vertigo drug. This systematic review aimed to identify the effectiveness Objective: of betahistine in vertigo patients Systematic research was done by using PubMed and Cochrane. with . Methods: following terms to search: “vertigo medication”, “betahistine”, “betahistine dihydrochloride”, “betahistine mesilate”, and “betahistine in vertigo". The quality of randomized controlled trial (RCT) study is assesed by using Jadad score by and he selected studies were reviewed by using PRISMA checklist as the guidance. There were 2669 citation t Results: from PubMed and Cohcrane. After adjusting for inclusion and exclusion criteria, the final result was a total 6 RCT studies included in this review. One study was discarded because lack of quality as an RCT study, thus remained 5 studies. All selected studies were RCT published in English within the last 10 years, involved subjects with vertigo. Each study was compared betahistine to: different dose of betahistine, diuretics, promethazine, dietary salt restriction, or Semont's maneuver. Among 5 studies, 4 studies prove betahistine is an effective drug in vertigo Conclusion: treatment. Keywords: betahistine, vertigo, systematic review Received: 22 December 2017 Revised: 17 January 2018 Accepted: 9 February 2018 Review Article www.ajpp.in 6 Asian Journal of Pharmacy and Pharmacology 2018; 4(1): 6-12 https://doi.org/10.31024/ajpp.2018.4.1.2