Chronic functional dizziness: rational approaches to diagnosis and treatment in outpatient practice

Functional dizziness (FD) is defined as persistent postural perceptual dizziness and is the most common cause of chronic non-rotatory dizziness. In routine clinical practice, there are difficulties and errors in both the diagnosis and treatment of patients with FD. This article presents clinical observations of patients with FD and discusses manifestations, approaches to diagnosis and therapy in outpatient practice. Management of patients with FD should be based on effective communication between the physician and the patient using psychotherapy methods, the creation of an individual treatment strategy that includes vestibular exercises, rehabilitation, and the use of evidence-based pharmacotherapy, with justification of the pathogenetic mechanisms of the leading role of the serotonergic system in neurotransmitter imbalance. Based on the evidence presented in the scientific literature and clinical experience, it is considered appropriate to prescribe Vespireit® to all groups of patients with FD to reduce symptoms of dizziness and instability, restore a sense of balance, and reduce anxiety and vegetative symptoms.