SHOULD I USE MEDICINE FOR VERTIGO?
Have you thought about taking medicine for vertigo or dizziness and have questions about its effectiveness? You’re not the only one.
I have many patients that go to the Emergency Room or their physician and are prescribed medicine for vertigo, most commonly Meclizine or Antivert. Meclizine is an antihistamine that is used to prevent and treat nausea, vomiting, and dizziness caused by motion sickness or vertigo.
How does Meclizine work?
It is a commonly prescribed medication for vertigo that can help in an acute flare-up because it works as a vestibular suppressant. This means the medication will reduce the input of the vestibular apparatus (inner ear balance center) so you do not get a chance to feel the room spinning; basically “shutting off” the inner ear nerve.
Is medication effective?
This definitely depends on the root cause of your symptoms. Taking a pill without properly identifying the diagnosis can lead to poor outcomes and frustration. Fortunately, a trained professional in inner ear disorders like a certified vestibular therapist or ENT can help you with identifying the source of your dizziness.
Typical medication options
The specific diagnosis dictates which of these treatment options is the best for each patient:
Acute vertigo is best treated with nonspecific medication such as meclizine. These medications are eventually weaned as they can prevent healing over the long term. Commonly used to treat the symptoms of acute Meniere’s disease attacks or onset vestibular neuronitis.
Migraines are episodes of symptoms that include vertigo/dizziness, motion sickness, visual aura, light sensitivity, and may or may not include a headache. Migraines are most responsive to migraine medication, not meclizine. A specialized neurologist may assist with the best medication for migraine-associated vertigo.
Motion sickness or spatial disorientation. This commonly happens when traveling, driving, or even being in a visually stimulating environment like a casino or busy store. The best treatment is often vestibular therapy. However, meclizine can be used sparingly for dizziness with this issue. If nausea occurs your physician may recommend Zofran or Phenergan. Learn more here about the difference between these two anti-nausea drugs: Zofran vs Phenergan.
Conditions affected by fluid imbalances of the inner ear, like Meniere’s Disease, are commonly treated by diuretics or “water pills”. Your physician will work with you to prescribe the right balance of medication so as not to drop your blood pressure too low when using diuretics.
Conservative treatment options for dizziness
Medication is not necessary in all cases of dizziness and a well-trained vestibular therapist can help you navigate what the best treatment option may be. Physical Therapists are often great educators and advocates for you in communicating your goals with physicians. Let’s explore some therapy options.
Dizziness that only occurs within the first five minutes of standing is typically due to blood pressure dropping (orthostatic hypotension). Your physician or therapist may guide you to wearing thigh-high compression stockings, abdominal binders, raising the head of the bed, or increasing salt intake and fluids.
Intermittent vertigo provoked by the movement of the head or neck typically responds to a special type of physical therapy called vestibular rehabilitation.
Spinning vertigo provoked by very specific movements such as lying down in bed or rolling over in bed may be Benign Paroxysmal Positional Vertigo – which typically responds very well to a specific sequence of movements known as canalith repositioning maneuvers. While there are many options online, I always think it best to have them performed by a professional.
Constant “floaty” or an “off sensation” associated with neck stiffness and headache behind the eyes could be a cervicogenic headache. Cervicogenic dizziness responds very well to manual muscle work, stretching, postural correction, and sometimes muscle relaxers. Patients respond very well to physical therapy for cervical dizziness.
Dizziness from triggers. By educating and journaling triggers to your dizziness like foods, lack of sleep, caffeine, weather changes, or salt a Physical Therapist can help you manage your condition through lifestyle modification. Disorders like, migraines, Meniere’s, and endolymphatic hydrops can all respond well to behavioral changes and avoid the need for more medication.
As you can see, medication is helpful in some acute scenarios. However, the main takeaway is that you should identify the root cause of your dizziness not just use a ‘band-aid” to cover symptoms. By scheduling an evaluation with Custom Care Rehab, you may find the answer you have been looking for all this time. If you have never tried vestibular therapy, you may be missing out on the full potential of a balanced and symptom-free life. Call Custom Care Rehab to see if you are a good candidate for vestibular therapy.
