AND OBJECTIVE: First-line serotonergic antidepressants achieve clinical response in approximately 60-65% of patients with persistent postural-perceptual dizziness (PPPD), leaving a substantial refractory population. Aripiprazole, a serotonin-dopamine modulator with partial D2 and 5-HT1A agonism and 5-HT2A antagonism, may address dopaminergic and emotional dysregulation insufficiently controlled by serotonergic...
Preliminary retrospective pilot data only — no actionable change to prescribing practice is warranted until controlled prospective studies are completed.
As refractory functional dizziness remains a significant management challenge, identifying viable second-line pharmacological options could meaningfully expand treatment pathways for a difficult-to-treat patient population.
- 01Pilot retrospective design; findings are hypothesis-generating, not practice-changing.
- 02Target condition is PPPD and related functional dizziness disorders unresponsive to serotonergic antidepressants.
- 03Aripiprazole was evaluated as a second-line agent in this heterogeneous cohort.
- 04Published in Frontiers in Neurology (DOI: 10.3389/fneur.2026.1858965).
- 05Cohort was heterogeneous, limiting generalisability of any observed effects.
Aripiprazole may be effective as second-line pharmacotherapy for refractory functional dizziness disorders including PPPD.
studypartially supportedPatients with functional dizziness unresponsive to first-line serotonergic antidepressants may respond to aripiprazole.
studypartially supported- PMID
- 42318238
- DOI
- 10.3389/fneur.2026.1858965.
- Journal
- Frontiers in Neurology
- Publication type
- research_article
- Evidence level
- 4
- Population
- Patients with refractory functional dizziness disorders (including PPPD) unresponsive to first-line serotonergic antidepressants
- Intervention
- Aripiprazole as second-line pharmacotherapy
Primary outcomes
Clinical response to aripiprazole in refractory functional dizziness; Tolerability and safety of aripiprazole in this population