2025 Volume 71 Issue 5 Pages 211-218
In the treatment of Persistent Postural-Perceptual Dizziness (PPPD), low-dose Selective Serotonin Reuptake Inhibitors (SSRIs) have been found to be beneficial in promoting treatment adherence while minimizing adverse effects. Previously, we reported a 75.9% efficacy rate in patients who were followed up for more than 10 weeks. This study evaluated patients with > 20 weeks of follow-up to determine the necessary treatment duration. Among patients who experienced a relapse during continued medication, 57.1% (12 of 21 cases) showed improvement by continuing treatment for an average of 8.0 ± 4.6 weeks after the relapse, with the relapse occurring at an average of 35.0 ± 28.3 weeks. These findings suggested that SSRI treatment should be continued for at least 43 weeks. In cases with relapse after the discontinuation of treatment, a significant correlation (p < 0.05) was observed between the duration of initial treatment (mean 27.4 ± 18.4 weeks) and the time to relapse (mean 57.9 ± 28.8 weeks). This finding implies that longer SSRI use may delay relapse. Two strategies were proposed: (1) a continuous treatment period of approximately 85.3 weeks may prevent relapse; (2) after 27.4 weeks of treatment, followed by 57.9 weeks off medication, a preventive 10-week course may be beneficial. These findings may help to guide the optimal treatment duration for PPPD.
