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.
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.