Overview

No blanket rules apply to medication to treat dizziness  – your doctor needs to advise on the suitability of particular medications for your individual situation.

If stress and anxiety or depression are issues, they need to be treated – you may not need to be treated with medicine. You might respond to the support of a psychologist or cognitive behaviour therapist. However there is definitely a time and a place for using medication to treat some dizziness disorders and related stress, anxiety, and depression.

The medications referred to on this page have been approved for use in Canada.

Vestibular suppressants

Vestibular suppressants are used to modify the intensity of symptoms. They may reduce motion sensitivity as well as nystagmus (involuntary eye movements) brought on by a malfunction in the inner-ear balance mechanism.

Vestibular suppressants might make you feel better in the short term. They are good for acute attacks of dizziness or for a time when symptoms are so bad that you cannot complete functions of daily living. Getting relief from symptoms and waiting for the spell to pass may be all that is needed.

However vestibular suppressants are not a long-term therapeutic ally. They suppress the very thing that we are trying to rehabilitate. If you have a vestibular loss your brain needs to adapt to it. Vestibular suppressants stop your brain from compensating for that loss. They make your recovery much slower and inhibit progress. It is generally agreed that vestibular suppressants should only be used for the first 24 hours.

There are three general classes of drugs that are vestibular suppressants: benzodiazepines, antihistamines (such as betahistine) and anticholinergics.

Betahistine (Serc^®) is prescribed to almost every person who complains of dizziness. It is generally safe to take. Some studies have found that it works to control vertigo attacks, but other studies have found that it does not work any better than a placebo. Betahistine is used in Europe and Canada, but not in the United States. It has few side effects for most people, and seems to work for some people, so your doctor may suggest trying it to see if it works for you.

Side effects of vestibular suppressants include increased falls risk and drowsiness. You must be extremely careful with driving and other risky activities because the combination of dizziness with drowsiness can be hazardous. Older people are at greater risk for side effects of vestibular suppressants. Some are habit forming and may cause withdrawal symptoms if you stop taking them.

Medication for nausea

Antiemetics (meaning preventing vomiting) are used to treat nausea during acute dizziness. Oral forms of these drugs are used for milder nausea. Suppositories are used for people with prolonged vomiting. Antiemetics may be injected if you visit an emergency room or are admitted to hospital.

Dimenhydrinate (Gravol^®) is an over-the-counter medication that can help with nausea. It can make you drowsy.

Anti-anxiety and anti-depression medications

Other anti-anxiety and anti-depression medications do not pose the same problems as benzodiazepines because they are not vestibular suppressants. Certain anti-depression medications help with some inner ear balance disorders. For example, antidepressants have been shown to be helpful for many people with persistent postural-perception disorder (PPPD) and vestibular migraine. In this instance, they are not used because the patient is depressed, but because experience has shown that such medications prove helpful in reducing vestibular symptoms.

Medications used for specific dizziness disorders and symptoms

Some medications are specific to particular dizziness disorders and are described on our pages describing the disorder or symptom:

• acoustic neuroma
• Ménières disease
• motion and cyber sickness
• PPPD
• vestibular migraine
• vestibular neuritis
• vestibular paroxysmia
• hearing loss

Precautions for taking medication

• Always talk to your doctor first before trying any new medication or supplement. This includes prescription drugs and over-the-counter preparations.
• When you take any medication or supplement, talk with a pharmacist to find out which ones interact with other drugs you are taking. All medications and supplements interact with each other. Taking some medications at the same time reduces effectiveness or cause dangerous side effects. This is especially a concern if you have heart disease, high blood pressure or diabetes.