Vertigo Medications and When to Use Them
Dr. Ryan Klopfer • May 10, 2022
Vertigo is a symptom that feels like dizziness or a spinning sensation while standing still. While vertigo itself is not life-threatening, vertigo attacks can be quite disorienting. These symptoms can become more dangerous in elderly patients prone to dizzy spells.
Medication management with drugs like meclizine, an antihistamine, and migraine medications are often used to treat vertigo symptoms. Your doctor may also recommend medications to treat the underlying conditions causing your vertigo.
While many of these drugs can treat vertigo symptoms quite quickly, most should be viewed as a short-term solution in vertigo patients.
How Types of Vertigo Are Diagnosed
There are 2 main types of vertigo: peripheral and central vertigo. Peripheral vertigo is much more common and typically caused by inner ear conditions. Central vertigo can stem from central nervous system disorders like multiple sclerosis, strokes, or brain illnesses or infections.
Cervical vertigo is often considered a third type by many vertigo specialists, especially following a neck injury or head trauma.
What triggers vertigo attacks? Head injury, an inner ear condition, or unexpected head movements can all trigger vertigo attacks. Common underlying causes of vertigo include:
- Benign paroxysmal positional vertigo (BPPV)
- Labyrinthitis and similar ear infections
- Meniere’s disease
- Vestibular neuritis and similar conditions affecting the vestibular nerve
- Benign tumors, e.g. acoustic neuroma
- Brainstem injuries or other head and neck trauma
- Vestibular migraines
A vertigo diagnosis typically comes with a primary diagnosis for the underlying cause of your symptoms. Your doctor will ask for a detailed health history and account of your symptoms, including what you were doing just before your first vertigo attack. From there, your diagnosis may include:
- Head movement testing : Tests like the Dix-Hallpike maneuver determine whether your vertigo is caused by an inner ear disorder like BPPV. Your doctor looks for rapid eye movements, or nystagmus, during the test.
- Balance tests : The Romberg test assesses your balance and gait. It’s a common test neurologists use to measure patients’ balance and positional awareness.
- Hearing tests : Vertigo symptoms may include hearing dysfunction, like hearing loss and tinnitus. Your doctor may refer you to an audiologist for more testing if this is the case.
- Medical imaging : Your doctor may order magnetic resonance imaging (MRI) scans or computerized tomography (CT) scans for a closer look at suspected areas of concern. Scans may reveal inner ear conditions or trauma causing your symptoms.
Once your primary care physician understands the case of your vertigo, they may prescribe medication as part of your vertigo treatment plan.
When Vertigo May Require Medication
In some cases of vertigo, medication may provide some immediate relief as you work with your physician on identifying the underlying causes of your dizziness. Medications are typically prescribed to treat acute vertigo attacks, rather than as a long-term strategy.
For example, migraine sufferers may benefit from migraine prevention medications when exposed to known migraine triggers. Patients with vertigo due to blood pressure dysregulation may benefit from calcium channel blockers.
Vertigo patients with underlying neurological conditions may also benefit from drugs that address those conditions and improve their overall quality of life. The focus for many patients is simpler: They want to reduce episodes of vertigo.
What is best medicine for vertigo? The best medicine for vertigo in many patients is medication that relieves nausea and dizziness, the primary symptoms reported by vertigo sufferers. This includes dimenhydrinate and meclizine, medications often prescribed for motion sickness.
Common Vertigo Medications
What are some of the common medications for vertigo? Some of the most common medications for vertigo are antihistamines, benzodiazepines, diuretics, and corticosteroids.
Medications are prescribed based on your symptoms. Some target inflammation, while others prevent nausea or vomiting. Most are meant for acute symptoms only. Before taking any prescribed medication, make sure your doctor knows about any drug allergies.
You should also report medications you are already on to avoid interactions that may worsen your symptoms. Dizziness, for example, is a side effect of many medications.
What are the side effects of some of these medications? The side effects of some of these medications may resemble vertigo. From there, side effects vary by medication, as drug treatment for vertigo includes a wide variety of medications.
We’ll detail possible side effects with each category of medication frequently prescribed for vertigo symptoms. Note: alcohol should always be avoided with any vertigo medication.
Antihistamines
Doctors often recommend antihistamines, or allergy medications, to combat the nausea and vomiting that accompany peripheral vertigo. Some anticholinergics and antiemetics fall under this category, as well.
Antiemetics in particular work by blocking the chemical messengers in the brain that cause those feelings of nausea. They are commonly prescribed for patients undergoing chemotherapy. More common antihistamines used for vertigo include:
- Meclizine : Antivert, Bonine
- Dimenhydrainate : Dramamine
- Diphenhydramine : Benadryl
- Promethazine : Phenergan
Many of these medications are available over-the-counter. Before using them for your episodes of vertigo, it’s important to speak to your primary care physician first.
Some of these drugs may interact with other medications you’re taking. Possible side effects of antihistamines include:
- Extreme fatigue
- Headaches
- Dry mouth
- Vision problems
- Low blood pressure
Benzodiazepines
Benzodiazepines are anti-anxiety medications that may also relieve dizziness in vertigo patients. They work by suppressing the vestibular system and essentially acting as a sedative. These drugs should only be prescribed in small doses.
Benzodiazepines commonly prescribed for vertigo include:
- Diazepam : Valium, Diastat
- Lorazepam : Ativan
These drugs come with a number of precautions, including a risk of addiction. Benzodiazepines should not be prescribed as a long-term strategy for vertigo sufferers, as they may come with withdrawal symptoms once you stop taking them.
Additional side effects include:
- Heachaches
- Confusion
- Muscle weakness
- Memory problems
- Drowsiness
- SIrritability
- Mood disorders, like depression
Diuretics
Diuretics, or water pills, are a common treatment for inner ear disorders like Meniere’s disease. They may also allieviate symptoms of hearing dysfunction in some vertigo sufferers by reducing fluid in the ear. Frequently prescribed diuretics for vertigo sufferers include:
- Acetazolamide : Diamox Sequels
- Triamterene : Dyrenium
There is evidence that the drug may also lower blood pressure to dangerous levels in some patients. It’s important to share a complete health history with your doctor before starting any medication regimen, especially if you have problems with blood pressure regulation.
Additional side effects of these drugs may include:
- muscle cramps
- Headaches
- Dehydration
- Joint pain
- Lightheadedness
- Increased urination.
Corticosteroids
Corticosteroids are steroid drugs often prescribed for vertigo patients with inner ear disorders, including inner ear inflammation. They work by reducing inflammation and swelling that cause vertigo symptoms.
These drugs are typically prescribed for short-term use until your condition improves. Corticosteroids commonly prescribed for vertigo patients include:
- Prednisone : Prednisone Intensol, Deltasone
- Dexamethasone : Decadron, Solurex
Studies show mixed results with these medications in vertigo patients. One study showed little evidence that the medication works with vestibular neuritis patients. Another reported positive results in Meniere’s patients.
Your own success on the drug may depend on the exact cause of your symptoms. Possible side effects include:
- Upset stomach
- Headache
- Sleep problems
- Mood disorders
Other Treatment Options
It is important to note that treating the underlying cause of your vertigo is the best first course of action for long-term relief. Medication management may help relieve your symptoms, but in many cases of vertigo, it won’t address the true cause of your dizziness.
In some cases, medications may simply mask what’s really going on, especially if you’re taking medications without a direct diagnosis for the cause of your vertigo. Outside of medication, a complete vertigo treatment plan may include:
- Vertigo exercises : Canalith repositioning techniques like the Epley maneuver are frequently used in the treatment of vertigo. Modified exercises may also be used as home remedies for symptoms of vertigo.
- Vestibular rehabilitation : This physical therapy approach works well for vertigo sufferers with vestibular disorders or balance disorders. A physical therapist works with you to improve balance, coordination, and stability.
- Lifestyle changes : Your healthcare provider may suggest ways to prevent future vertigo attacks. This may include adjusting your sleep habits and diet, reducing your stress, and becoming more aware of your daily movements.
- Chiropractic care : Vertigo caused by misalignment in the upper cervical spine can respond to chiropractic care. If this is the case for your vertigo, a chiropractor can use gentle repositioning maneuvers to readjust those misalignments.
Let’s Get Started
If your vertigo symptoms are the result of a neck injury or misalignment in your upper cervical spine, help is waiting for you at Georgia Upper Cervical Chiropractic. Long-term relief for our patients is our primary goal, without a focus on long-term medication.
Ready to get to the root of your problem with chiropractic care? We’re currently accepting new patients at our Ball Ground office.
Sources
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