Meclizine is commonly prescribed for people with dizziness and vertigo, including older adults. In some cases, it may be needed but in other cases it is dangerous.
Older adults are often frequently told that there’s nothing they can do about the vertigo because they are older. They are advised to take the meclizine as prescribed to reduce their discomfort. Frequently, no further care is recommended.
Meclizine is on the BEERS criteria is “not recommended” for older adults, with moderate evidence to support that recommendation.
In this article we will talk about what makes Meclizine dangerous for treating vertigo, especially in older adults.
Medication Side Effects Increase Risk of Falling
There are three reasons why Meclizine is dangerous for older adults related to medication side effects and falls:
- Meclizine increases the risk of falling due to Medication Side Effects.
- Side effects of Meclizine include dizziness, drowsiness and blurry vision.
- Those side effects can increase the risk of falling for people of any age, but especially for older adults who may have other problems like muscle weakness and vision problems.
More than That…
More than just the side effects of the medication and falls, there are a few other reasons why meclizine is dangerous for long term use in older adults with dizziness and vertigo.
Meclizine Is Dangerous Because It Masks the Problem
Meclizine is dangerous because it masks the symptoms of dizziness and vertigo to reduce discomfort, but does not correct the underlying problem.
The lack of root cause leaves the person with a balance impairment that has not been addressed, even if they no longer feel dizzy or spinny on the medication.
An unidentified and unaddressed balance impairment increases the risk of falls.
Many older patients I have met who sustained a serious fall-related injury are on meclizine and have been taking it for many years to mask their dizziness.
Anti-Cholinergic Effect on the Brain
Meclizine is dangerous because it works to reduce dizziness and vertigo by reducing the activity of a chemical called acetylcholine in the brain. Medications that are currently marketed to stop the progression of dementia increase the activity of acetylcholine in the brain.
Hmmm… think about that for a minute.
Anticholinergic medications have been shown in research to cause irreversible cognitive impairment with long term use. Meclizine is dangerous for treating vertigo because the long-term use of Meclizine can cause irreversible cognitive impairment.
Yes that’s right! Even so, older adults are still commonly prescribed Meclizine when they complain of dizziness or vertigo.
A Better Plan
Since Meclizine is dangerous for treating vertigo especially in older adults, I would like to propose an alternative approach.
Instead of recommending Meclizine as a long-term solution of vertigo, people with dizziness, vertigo, and balance problems should be referred to Vestibular rehabilitation physical therapy to identify and eliminate the root cause of the dizziness and vertigo if possible.
Take Caution and Next Steps
Please note: All medications should be taken as prescribed by your doctor. If you have been prescribed meclizine, you must follow up with your doctor to discuss your concerns and request for the medication to be reduced if possible.
For people with a poor prognosis of vestibular recovery, meclizine may be appropriate for long term use. However, the accurate prognosis can not be determined until an exam by a vestibular expert provider has been conducted.
Meclizine may also be helpful to take short term until proper vestibular care can be found. Sometimes, it takes awhile to find the right provider.
Disclaimer
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.
Wonderful information. I will certainly keep this article and share with any of my patients who are on this drug.
I am currently on the prescription drug meclizine and was looking for any input i can get and help in making it less inhibiting to what i am experiencing
Hi Sharon,
You should talk to the doctor who prescribed the medication to you about your questions and concerns regarding this drug. I am sorry I cannot advise you on that.
Also you may want to consult a Vestibular Physical therapist.
You can use this article to search for one in your area.
Best wishes,
Kim Bell, DPT
Dr. Kimberley can meclizen cause a mild stroke if taken long period of time like 10 years plus twice a day????? cause of yesterday my father had a mild stroke thank god hes ok but this VA doctor took him off of the meds on friday the 25th of march im just wondering if it can cause a stroke!!!
Hi Kelly,
I am sorry to hear your father had a mild stroke! Thank God he is ok.
I have never heard of meclizine causing a stroke. I don’t think that could cause a stroke, but I would defer to your dad’s doctor on his opinion.
I hope he feels better soon!
Sincerely,
Kim Bell, DPT
I was taking this medication and it did nothing for me.
I am terribly off balance, dizzy and lightheaded ALL the time!
I will now try to find a Vestibular Physical Therapist.
Thanks 🙏🏾
Hi Bessie,
You should take your medications as prescribed by your doctor and talk to your doctor before making any changes.
If you are supposed to take meclizine regularly, your doctor may be able to switch your meclizine to “as needed” if it is not helping you.
You can use this article to search for a vestibular physical therapist in your area.
I hope you feel better soon!
Good idea. I just started treatment a couple of weeks ago and in fact going today for more. It is helping!!
Try to do a therapy for dizziness. It will help you and get you better if the ears cause that.
My husband is 83. He has broken a bone in his neck as a result of falling from a vertigo spell. He cannot exercise due to his Neck brace.
He still has dizziness. is meclizine ok? What can we do?
Hi Diane,
I have to always advise that you take all medications as prescribed and discuss any changes with the prescribing doctor.
Healing the broken bone in his neck is top priority.
Once your husband is cleared for physical activity by his doctor, you may want to seek out vestibular physical therapy for treatment of vertigo and imbalance.
This article can help you search for a local vestibular PT.
I suggest you write up a case summary using this article, to share with all his providers.
In the meantime, the meclizine may help him with the quality of life day to day.
Best wishes to you both!
I was prescribed Meclizine by ER which was the wrong diagnosis. After several specialists, one which was concerned about balance particularly with regular use. After much concern on my part, I started taking it regularly by my PCP who was unsure of my diagnosis. I am 73 years old. I had no warning of any side effects, but fell while just walking. I do have physical therapy referral to them, plus was neurolgist, and cardiologist. Fall was really scary though I didn’t hit my head, injured wrist and knees and then had a dissociative episode due to the trauma. Though I don’t think my PCP had any idea this could happen.
Am I mistaken, or can you not purchase this medication OVC? (over the counter,….without a prescription).
Hi Robert,
The over the counter brand names that people often use instead of prescription meclizine are Bonine and Dramamine. You can find them at most drug stores.
Be sure you talk to your doctor before starting any new medications.
If you have meniere’s disease, which I have had for 30 years, what other choices are there?
Hi Robert,
There are a few options for medications for Meniere’s disease, so each patient should seek individual medical advice from the prescribing physician.
The medication management also depends on which country you live in, since the prescription drugs available and prescribing habits may vary from country to country.
Meniere’s disease is frequently managed with diuretic medications or water pills. That may help prevent vertigo attacks.
There are different water pills that may be prescribed, such as HCTZ.
Other patients may take a histamine analogue like betahistine to reduce vertigo attacks.
Reducing salt intake is an important dietary change for people with Meniere’s disease.
There are higher levels of management that patients may need if dietary changes and medications do not help.
Also patients with Meniere’s disease may have co-occuring issues that can be treated with vestibular PT to reduce overall discomfort.
I discuss that more in this article.
I hope that helps!
I thought I had vertigo, but was diagnosed with crystals in my ear getting out of line. the therapist said there was no medication for the condition. The only thing I could do was lay with my head off the bed on the left and right side three times each sitting up each time and then laying back down. Giving each time 3 to 5 minutes.
Hi Patricia,
Thank you for sharing your story!
This article discusses BPPV treatment.
This article discusses vestibular rehab.
This article can help you search for a vestibular provider who can perform hands on treatments for BPPV crystals.
I have a script, but barely use it. While my regular doctor prescribed it, I have been treated by ENTs and was extensively tested (including an MRI and hearing tests, eye movement tests,etc.), as well as given epley movements. It did not resolve the problem. I was also given an anti-viral as apparently an active infection was the root cause at the time. However, I had had vertigo off and on for years, including ear infections in my 30’s and 40’s and complaints of balance issues in my 20’s.
I had rehab, but I believe the worst of it (I had rapid eye movement when laying on my sides, could see and feel movement, had bouts if I turned on my side, and felt like I was walking on a cruise ship when upright and walking or standing still).
A couple years later, a vestibular specialist suggested it was related to nerve damage. My brain just isn’t getting the proper signals from my inner ears. I also have chronic post nasal drip, a constantly runny nose which runs worst when I eat. So lots of fluid in my inner ears all the time.
The vertigo is constantly present, but tolerable. I will have what I call “vertigo days”. Those are days when I can activelyfeel movement more that usual. I tend to list to my left.
Then I have bad vertigo days. And only then willI I reach for my meds, which are usually expired by then. So I just cope. Today I’m here because this is a bad day and my meds are 2 years expired and it’s the weekend so I can’t ask for a refill. I turned over in bed and had doozy of spell and I’m ship-walking. If anyone has been on a cruise for the first time, they know what I mean.
All this started with a sudden sensation of the floor opening up while i was in the shower about 15-20 years ago and i fell against the shower wall. I do not fear falling. I do not fear breaking any bones. I’m nearly 70, but exercise with weights, pilates, core work, and floor work entry other day.
I had only one really scary, I could have really be injured incident and that was when I was falling backwards without any awareness whatsoever. Only when I reached a point when my feet shifted at whatever angle my entire body had reached did I realize I was falling back and I grabbed a big service table in front of me to pull myself forward. I was falling straight back onto a hard cafeteria floor at work. I could have sustained severe TBI.
I no longer drive although I have had to drive for emergency reasons, but otherwise do not. Several dx have been suggestions. No one really said definitively this is why you have vertigo, we found the error cause. I think I have a combo of nerve damage, excessive fluid in my inner ears, and who knows what else.
My mom suffered debilitating vertigo, which would sometimes “fix” (i.e. she would see the world upside down). Hers was sudden bouts, while I usually have warnings that today will be a “bad vertigo day”.
I was offered rehab by the vestibular specialist, but couldn’t participate as they did not have evening hours. I’m retired now and can do it. I might give it try.
This is long, but hopefully with so many details of my journey, other sufferers will find relatable details.
I wanted to add I do not restrict my movements asI believe my brain would become accustomed. I’m other words I bend down, twist, roll over in bed behave normally. Only on really bad days like today willI restrict body and head movements. I’m taking a musinex, in the hop it’ll dry up some of the fluid in my sinuses and ears. Thanks for reading
Yes my doctor prescribe this to me I’m very afraid to use it I have so many other health issues don’t need to invite another one it was prescribed by my car just I think not worth the risk
Hi Mary,
You should take all medications as prescribed by your doctor and discuss any concerns with your doctor before making any changes.
I hope you feel better soon!
If you want to look for a doctor or physical therapist who treats vertigo and dizziness, you can search online here.