I still find it shocking that most of the medications for dizziness actually causes dizziness as a side effect!
The benefits of medication for dizziness are to reduce the symptoms, to allow the person to feel more comfortable, and improve their day-to-day function. Anyone who has ever suffered with dizziness or vertigo can appreciate the need for that.
Side effects of some commonly recommended medications for dizziness include dizziness, drowsiness, and blurry vision. Jaw drop!
These medication side effects can actually increase falls, which is a life threatening condition in itself.
Certain medications for dizziness, such as Class I antihistamines like meclizine, have an anticholinergic effect on the brain. With long term use, anticholinergic medications can cause irreversible cognitive impairment or dementia.
Getting dementia is one of the biggest fears I hear people express as they get older.
An Explanation of Anticholinergic Effects
I will explain what “anticholinergic” means and how it relates to dementia.
The most common medications on the market for preventing the progression of dementia are designed to increase the activity of a certain chemical in the brain called “acetylcholine.”
That’s one theory of how prescription drugs may prevent dementia from getting worse in people who are diagnosed with dementia.
Unfortunately, many of the common prescription drugs and over-the-counter medicines for dizziness and vertigo are anticholinergic.
This means that the medication reduces acetylcholine activity in the brain.
I have seen many people who have never had a root cause evaluation by a vestibular expert and were prescribed anticholinergic medication indefinitely.
The results of their MRI or the CT scan was clear. Their physician was able to rule out a stroke.
The results of the cardiac testing was clear, so the physician was able to rule out a heart attack.
Maybe they were even referred to an ENT, but no explanation for the dizziness or vertigo was found.
Then the medications prescribed for dizziness or vertigo were prescribed daily, twice a day, or even up to three times per day with planned no end point.
If someone takes anticholinergic medications for years, they have a much higher risk of dementia.
This is sad but true, and proven in research studies.
I was actually informed about this problem by a physician who I have worked closely with for over a decade. Sadly, her father was diagnosed with early onset dementia from taking an anticholinergic medication for bladder control for many years. She was not even aware of these long term consequences until it affected her family.
For that reason, I am never surprised when I meet physicians who have never heard of this type of long term anticholinergic affect on the brain from certain medications that reduce acetylcholine.
My goal is to educate people.
I want to emphasize the importance of taking all medications as instructed by your doctor.
Never stop or start a new medication without medical supervision by your physician.
I am not advising anyone to stop taking medicine as your doctor prescribed.
After your Vestibular Evaluation, if the specialist thinks you will benefit from taking the medications long term, then that is what is recommended. That happens in some cases with a poor prognosis for a complete recovery.
You might be surprised!
Many people that I see have never had a comprehensive evaluation by a skilled Vestibular provider.
Once that evaluation is completed, it often turns out that they have been on medicine for dizziness for so long, but the symptoms can resolved with Vestibular physical therapy.
There is a huge body of research supporting a consultation with a Vestibular Physical Therapist to resolve dizziness, vertigo, and balance problems.
This is a medical specialty so most general providers can not offer this type of care.
Once I complete a comprehensive root cause evaluation for my patients, I work closely with their physicians to ensure that the patients is on the lowest possible dose of the necessary medications, if any are needed.
If the Vestibular Physical Therapy is successfully resolving the symptoms, I also frequently request for physicians to wean their patients off the medications that have been prescribed for treating symptoms of dizziness and vertigo.
Many people are able to come off of medicine for dizziness altogether with the support and permission of their doctor, because their symptoms can be completely resolved through vestibular rehabilitation.
To read more helpful resources and information about dizziness and vertigo, please visit VertigoDetective.com.
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.