Dizziness and vertigo are frequent complaints in the clinic, but standardized treatments have not yet been established. Here we report three cases of dizziness and vertigo successfully treated with takushato. Case 1 involved a 38-year-old woman who experienced dizziness, which had made her feel as if she was sea sick for 2 years, and which was worsening. After taking takushato for a month, her dizziness improved.Because she complained of an abnormal pharyngeal sensation, her prescription was changed to hangekobokuto in combination with takushato, and her dizziness almost disappeared 2 months after her first visit. Case 2 involved a 61-year-old woman who had had dizziness and vertigo for 4 months. Although no abnormality was observed on MRI, she developed labile vertigo a few days later. After taking takushato for a month, she felt no dizziness or vertigo at all. Case 3 involved a 67-year-old woman in whom labile vertigo had developed even while supine for 2 months, and although receiving medication for a diagnosis of benign paroxysmal positional vertigo, did not improve. Triple dose takushato was remarkably effective, and improved her otological findings. Takushato is one hopeful option for the medical treatment of refractory dizziness and vertigo.

Takushato is a Kampo formula used for the treatment of dizziness and vertigo. Signs and symptoms suggestive of fluid retention have been regarded as clinical indications for takushato administration, but it is not clear if improvement of these signs and symptoms is related to the clinical efficacy of takushato, so we analyzed the correlation among these factors. Twenty patients who suffered from dizziness and vertigo were treated with takushato for 4 weeks. Before and after treatment, subjective symptoms and objective data including vestibular function tests were assessed, and correlation among the factors was analyzed. Improvement of patients' total symptoms was significantly correlated with improvement of fluid retention scores. Furthermore, improvement in vestibular function tests showed a trend toward correlation with that of fluid retention scores.These results suggest that improvement in the signs and symptoms of fluid retention is related to the clinical efficacy of takushato. We conclude that the presence of fluid retention is a reasonable clinical indication for takushato administration.