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Agents targeting the H<jats:sub>1<\/jats:sub> and H<jats:sub>3<\/jats:sub> receptors have been in clinical use for several decades as single agents. Nonetheless, effective management of vertigo proves elusive as many treatments largely address only associated symptoms, and with questionable efficacy. Additionally, the primary and limiting side effect of sedation is counterproductive to normal functioning and the natural recovery process occurring via central compensation. To address these issues, the timing of administration of betahistine, the mainstay H<jats:sub>3<\/jats:sub> antihistamine, can be fine\u2010tuned, while bioavailability is also being improved. Other approaches include antihistamine combination studies, devices, physical therapy and behavioural interventions. Recently demonstrated expression of H<jats:sub>4<\/jats:sub> receptors in the peripheral vestibular system represents a new potential drug target for treating vestibular disorders. A number of novel selective H<jats:sub>4<\/jats:sub> antagonists are active in vestibular models in vivo. The preclinical potential of SENS\u2010111 (Seliforant), an oral first\u2010in\u2010class selective H<jats:sub>4<\/jats:sub> antagonist is the only such molecule to date to be translated into the clinical setting. With an excellent safety profile and notable absence of sedation, encouraging outcomes in an induced vertigo model in healthy volunteers have led to ongoing clinical studies in acute unilateral vestibulopathy, with the hope that H<jats:sub>4<\/jats:sub> antagonists will offer new effective therapeutic options to patients suffering from vertigo.<\/jats:p>","DOI":"10.1111\/bcp.14046","type":"journal-article","created":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T16:34:24Z","timestamp":1562171664000},"page":"2255-2263","source":"Crossref","is-referenced-by-count":22,"title":["Management of peripheral vertigo with antihistamines: New options on the horizon"],"prefix":"10.1111","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0875-909X","authenticated-orcid":false,"given":"Jonas","family":"Dyhrfjeld\u2010Johnsen","sequence":"first","affiliation":[{"name":"Sensorion SA  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Attali","sequence":"additional","affiliation":[{"name":"Sensorion SA  Montpellier France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,7,22]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3233\/VES-2009-0343"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000691"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1241043"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0b013e32835c5fd4"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-444-63437-5.00005-4"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0082(97)00068-3"},{"issue":"3","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.3233\/VES-130494","article-title":"Neuropharmacological basis of vestibular system disorder treatment","volume":"23","author":"Soto E","year":"2013","journal-title":"J Vestib Res"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816689667"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/NPT.0000000000000120"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2016.03.013"},{"key":"e_1_2_12_12_1","unstructured":"HainT.Drug treatment of vertigo.2017[cited 2017 Sep 8];https:\/\/www.dizziness\u2010and\u2010balance.com\/treatment\/drug\/drugrx.html. 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