Do you have questions about medication for vertigo? You are not alone.
I had a patient recently who was experiencing vertigo and got relief with taking Meclizine prescribed by her doctor.
Meclizine is the generic name of a first generation antihistamine commonly prescribed for vertigo. The medication did relieve her vertigo symptoms so she thought she no longer had vertigo.
With her doctor’s approval, she stopped taking the Meclizine every day. But as soon as she tried to stop taking the Meclizine, her vertigo symptoms came right back.
Before she consulted with me, I had a chance to speak to her on the phone about her situation and I want to share with you what I told her. I explained to her the importance of determining the root cause of the vertigo symptoms and treating the root cause if possible.
The fact that she had a recurrence of symptoms when she went off the medication for vertigo recently tells me that the root cause of her symptoms has not been addressed and the underlying problem still exists. The medication was suppressing her daily symptoms but did not resolve the cause of the problem.
Below are the risks that she takes on if she continues to take medication for vertigo, instead of seeking care from a Vestibular Expert healthcare provider to identify and potentially resolve the root cause of vertigo.
Side effects of long term use of medication for vertigo
Meclizine has side effects of dizziness, drowsiness and blurry vision which often result in higher risk of falling for older adults.
Meclizine has an “anti-cholinergic” effect on the brain which results in irreversible cognitive impairment with long term use.
For those reasons, Meclizine is on the BEERS criteria list of medications that should not be prescribed to an older adult regardless of their symptoms.
But yet, it is still being prescribed everyday. I have met some older adults who take Meclizine as many as three times per day.
Effects of untreated root cause of vertigo
The Meclizine is a central nervous system suppressant, so it suppresses the feeling of vertigo. But the underlying cause of the vertigo is still present in the body.
For example, the most common inner ear cause of vertigo is BPPV. Untreated BPPV can cause balance problems, unsteadiness with walking and a foggy memory even if the Meclizine is suppressing the vertigo symptom of BPPV.
Unfortunately, people with BPPV who fall are more likely to sustain a fractured bone than fallers without BPPV.
Therefore, potentially adverse effects from a fall due to medicated, but untreated BPPV, present a serious risk for someone who has chosen to take this medication for vertigo instead of addressing the root cause.
When is medication for vertigo recommended
With all that said, there are some times and cases where Meclizine is appropriate. Three examples include short term use for new vertigo symptoms, situational use for motion sickness and long term use in cases with a poor prognosis for recovery.
Short term use of medication for vertigo
The research in Vestibular care supports the use of vestibular suppressants, such as Meclizine, for the first 48 hours of a new onset of vertigo. This medication for vertigo is helpful to bring relief and minimize discomfort for an acute case, or a new case.
Use of Meclizine interferes with the vestibular system’s ability to compensate for a new injury, which is why the Meclizine is not recommended in the literature beyond the first 48 hours.
Motion sickness relieved by medication for vertigo
Situational use of Meclizine may be appropriate for people who are going to engage in an activity that they know causes them to feel vertigo. For example, someone might get a prescription from their doctor for Meclizine to use as needed for car sickness, riding a roller coaster or motion sickness on a boat.
Long term use for poor prognosis
Talk to your doctor about your medication for vertigo
You have no way of knowing your prognosis for recovery from vertigo symptoms if a professional has not determined the root cause of your symptoms.
Always take medications as prescribed by your doctor and never stop taking a prescription medication without your doctor’s supervision.
If you have been prescribed Meclizine for long term use, you may want to discuss alternatives with your doctor like a referral to a Vestibular Expert physician or physical therapist for a root cause evaluation.
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.
Very helpful information thank you very much.
I have dealt with vestibular migraines for 20 years.I had a leading specialist who was kind but honest.
I take amitryptiline at night and the occasional meclizine when the nausea is severe.
I still have episodes that make life more difficult after all this time.
I really don’t think there’s much help for those of us who have this problem.
I am constantly disappointed by medical doctors who seem so aloof and treat you like an idiot.
Our medical system is a mess and it’s very disillusioning having to be a constant part of it.
Sending hope to those of you who can find a medical doctor who actually cares.
I have had dizzyness on and off for 4 yrs.
Am feeling hopeless and always dizzy.
I have been suffering from cervical vertigo since late October. Mine involved my neck. Not only that I suffered from dizziness & vomiting for hours! Would last all day. I had been admitted to emergency a brain scan was done thankfully nothing showed. I had extensive tests were done via an ENT doctor & he felt it was benign vertigo. I was given the prescription for meclizine as needed which I tried to do. Then I had an episode so bad, it was awful vomiting included. So I started taking the meclizine 3 times a day every day which helped. I’ve been with a therapist who has done wonders for my neck but like others here they don’t know the root cause. They try to recreate an episode to no avail therefore not agreeing that it’s not benign vertigo.
I’m so worried about being on this med but since haven’t suffered an episode. I have another appointment with an ENT & one for the neurologist.
This has been so dibilitating to say the least.
This article may be helpful, as I discuss dizziness related to the neck: Dizziness with Head Turns.
You may also want to watch my most popular online video here to learn more about dizziness and vertigo.
Hello!
Upon hx, research and symptoms I believe i have a new onset of cervical vertigo. No hx of migraines,
Frequent headaches, stroke, profuse vomiting, fever, or TBI or any dx of that matter. this started last Sunday and has persisted almost 1 week. Symptoms include On and off dizziness all day everyday, spinning, moderate neck pain, moderate nausea. Dizziness occurs more with looking down and bending neck.
I do have history of c6 and c7 disc bulges, Osteoarthritis and injury such as whip lash and career induced injuries fr patient care.
This has been very debilitating to say the least, I am Only 43 with no other medical conditions, this new onset started after a 3 hour hike up a mountain of only 1600 ft elevation. It was a moderate trail with lots of rocks and harsh pathways… Anyhow I was looking down almost the whole 3 hours of the hike to make sure I did trip or fall over rocks. The very next morning I felt like I had a huge hangover, spinning, dizzy, severe nausea, no profuse vomiting but sometimes i feel that salivating feeling and momentarily “hot sweat s”.
if I look Down I start to Either get dizzy and/or spinning. I’ve done the vertigo exercises, meclizine, hydration, trying to be cognizant of my posture, antihistamine, motrin and Tylenol, these methods barely
Take the edge off so I can walk eat and shower. I have 2 Little ones and feel like an awful, awful mother 🙁 as I can Only lay in bed all day for any relief.
Any info and advice would be appreciated!
-Jen
Hi Jen,
I am sorry to hear about all this!
This blog may help you further develop some ideas related to dizziness from the neck.
If possible, I suggest for you to find an orthopedic manual physical therapist near home on this Directory.
In the meantime, some of these tips may help.
I hope that helps!
I hope you feel better soon.
Sincerely,
Kim Bell, DPT
Hello thanks for your comment. Am I suppose To go to a specialist like an ears nose and throat doctor each time I get an episode of my vertigo?
Hi Annette,
Some Ear Nose and Throat Doctors can help with vertigo, while others may not be trained in that specialty. This blog explains more about that idea.
My suggestion is that you establish a relationship with a ENT doctor or vestibular physical therapist who can help you with vertigo.
You can use this blog to search for someone near you, if needed.
Then return to that same provider (if possible) if the vertigo ever recurs.
I hope that helps!
Some of my doctors do not want to know the whole picture.
They just say what is the one problem you want to discuss. They say make another appointment if there’s something else..
They are so busy that it is hard to get another appointment.
And things are related in your body so if you find a doctor that will listen listen in a timely manner of that what’s going on with your whole body instead of just one item you have a better opportunity for success!
I was diagnosed with Meniere’s Disease in 2013. I was constantly dizzy and lost my ability to walk. When I got out of the hospital after having MRI test, sinus tests and seeing every specialist out there, I was referred to a therapist for walking to learn how to live and cope with daily dizziness I was told. I’m dizzy every single day but have had 2 major episodes, in 2020 for 3 months and once again now. My new Dr prescribed Meclizine but it hasn’t helped yet. I have lost hearing in my right ear and a smaller percentage in my left ear. I’ve tried the smoothies I found online, vertigo exercises, I am currently using a humidifier, Neti-Pot for my sinus condition and such. I’m terrified that the dizziness and being off balanced will never go away so I can get back to work and my old life.
Your comments are my true feeling exactly. Doctors don’t care and talk like we are idiots.
I am suffering 24/7. With no help. Recently I was put on meclizine but it is not taking care of my problems.
Every day I suffer. Who can help me?
Hi Maria,
I’m sorry to hear you are still suffering. I suggest you take all your medication as prescribed and discuss your concerns with your doctor.
You can consult with a vestibular physical therapist by searching the healthcare provider directory at Vestibular.org.
Physical therapists may have more time allotted for your appointments than medical doctors can typically spend per patient.
I hope you find answers and get relief soon!
I agree. Had my first bout with vertigo, vestibular rehab ordered, but no appointments available right away, have meclizine but don’t want to take it all the time.
I have been taking meclizine 25mg (split in half) for my vertigo for about 2 years every night before bed and have now started getting blurred vision and some short memory issues. I will be turning 40 this year and do have a family history of Dementia. I have had my hearing and inner ear checked for any problems but it has all come back showing nothing wrong…please help I am at a loss and I still get vertigo even while I am sleeping, and the only thing that seems to help is when I take the meclizine….I don’t know what else to do.
Hi Christina,
I suggest you look for a Vestibular provider in your area using this blog article.
In another blog post, I share some Vertigo Home Remedies that can help.
The key is to identify and address the root cause of your symptoms.
Best wishes,
Dr. Kim Bell, DPT
Hi Christina,
I am doing the same thing you are doing taking Meclizine every night. I’ve been on it for a month now that is the only thing that gives me relief from the vertigo attacks. I don’t know what to do either. Doctors don’t know what is causing it all tests come back normal. Yet I am not normal my life is just feeling dizzy and unbalanced it’s so hard.
Hi Ana,
I have heard from so many people in a similar situation. I am working on two books right now, to help people who are not able to come to San Diego to see me in person.
The second book is an advanced discussion of causes of vertigo that I have found in people who don’t find any root cause with traditional healthcare.
I encourage you to sign up for my mailing list so you get notified when that second book is launched. You can find the sign up form on this Home Page.
I am sorry for what you are going through!
Should someone come off the meclizine slowly or is it safe to just discontinue use?
Hi Linda,
You should take your medication as prescribed by your doctor, and discuss any changes with your doctor before stopping a medication.
The prescribing physician can advise you on the safest way to get off of prescriptions.
Best wishes,
Kim Bell, DPT
You don’t mention Central Nervous System vertigo in your discussion. I have been through the testing and it has been determined that I do not have vestibular vertigo. My issues stem from exposure to nerve agent during the first Gulf War and meclizine has controlled it for many years. It is a very similar issue to the multiple chemical sensitivity that migrant farm workers face.
Hi Jim,
You are correct that I do not mention the central nervous system in this article. Thank you for making that point.
It is appropriate to use meclizine long term — if you know the root cause of vertigo and the prognosis for recovery is poor.
That is what I was talking about in the article when I said meclizine is appropriate for “…long term use in cases with a poor prognosis for recovery.”
In the case of a poor prognosis to resolve the root cause of vertigo, daily meclizine can help maintain quality of life.
Thank you for teasing that specific point out in more detail for the other readers. I am sure your comment will be helpful for many of the other readers!
I have suffered from vertigo on and off for 20 years. I have seen numerous vertigo specialists, who have determined it could be from bppv, Menieres disease, damaged inner ear etc etc
I have gone through every test in the book, multiple rounds of vestibular therapy with limited success.
My doc told me that sometimes a geriatric dose of the drug can help. For years i would take 3 – 6 mg per night before bed. I do notice some slight memory loss occasionally but am unsure of other options. Saw a opthamalic neurologist to see if any correlation between eyes and ears but they found none.
I have been trying to avoid taking meclizine but after flying for a day all of a sudden the dizziness and vertigo feelings are there again. Is there another medication someone can try that doesn’t have the anticholeric effects like meclizine? When I have to take it I only take 3 – 6 mg and usually one or two days a month. Should that cause the same problems?
Hi Damien,
That sounds miserable! I am sorry to hear about your unresolved vertigo and dizziness.
This article and this article discuss reasons why vestibular physical therapy may not work. There is a large body of evidence to support its efficacy.
If you have not already consulted with a Neuro-Optometrist, that may be a valuable step. You can find one using the Doctor Locator at COVD.org.
The anti-cholinergic effects of medications are documented to be cumulative over time.
Some of my patients keep a medication on hand, in case they need it occasionally or short term, such as during travel. I share more travel tips here and here.
I hope you can determine the root cause(s) of your discomfort so that you can target your management to the specific cause.
Even for people with multiple causes, it is possible to learn which set of symptoms is from which cause and respond accordingly.
Even if you cannot completely resolve the symptoms, managing them confidently and skillfully can improve your quality of life.
I wish you all the best!
Warmly,
Kim Bell, DPT
I have ringing in the ears just came on from nowherecan stress cause it
This article may help with your research: Are your ears ringing?
Have had insomnia for several months and now have vertigo! I have been taking tranzadone 50 mg. for sleep and now taking meclizine 25 mg for vertigo. I am 85 Years old. Was in ER a week ago and had CT scan & MRI etc. everything normal. Might have Meniere’s disease..I am concerned about taking these two pills each day. I can not fall asleep each night. Am very tired.. Are they safe for me to take at the same time at night?
Hi Maria,
I am sorry to hear how you are feeling!
That is great news about the “normal” results from the CT scan and MRI.
This article can help you find a Vestibular provider. They are specially trained to assess and treat vertigo.
That would be a great next step for you to determine the root cause of your symptoms.
You are very wise to ask questions about drug interactions with multiple prescriptions.
You can ask your pharmacist if it is safe for you to take this combination of medications.
You can also ask your prescribing doctor or the doctor’s nurse about any drug interactions.
The app I use to check for drug interactions for my patients is available on this page. There may be a fee to use it, so read the website carefully.
I also wrote this blog on Meniere’s disease that may be helpful.
This article has some Home Remedies that may help while you are trying to figure out what is causing this for you.
If you have some time, you may want to watch this lecture that I offer on Dizziness and Vertigo.
This video also may be helpful to you.
I hope you find answers and get relief soon!
Sincerely,
Dr. Kim Bell, DPT
I feel the same way. What’s the answer?
Excellent work. Thank you. I am a Nurse Practitioner and had my first bout of Vertigo a month ago. The exceptionally skillful PT that I saw dx BPPV bilat. Worked with me through the testing and exercises.
Thank you for your important work.
Hi Karen,
That is great news! Thank you for letting me know that my blog was helpful to you.
Cheers to my Vestibular PT colleague’s excellent work as well.
As awful as I am sure that experience was, you will be so much more prepared to respond when your patients complain of vertigo or dizziness.
As providers who have experienced vertigo ourselves, our compassion and empathy is of great comfort to our patients who are terrified and uncertain what to do.
Kind regards,
Kim Bell, DPT
Hi I just started the medicine it only helped for a few hours I’m still getting the bad dizzy spells like I’m going to fall over it happens a lot for the pass week I’m scared to move at times
Hi my name is Kyle. I had my first vertigo attack a week ago. I went to sleep and woke up with a bad spinning sensation.. My doctor prescribed meclizine. Thankfully it had stopped. Is it safe for me to stop taking the drugs, as it makes me feel worst when i am taking it?
Hi Kyle,
You should always take medications as prescribed. If your doctor prescribed the meclizine to be taken regularly, you can contact the prescribing doctor and ask for the medication to be changed to take “as needed.”
You can use this blog to find a Vestibular physical therapist in your area.
This blog has home remedies that may help.
This blog discusses BPPV, which is the most common cause of “waking up spinning.”
Best wishes for a full recovery,
Kim Bell, DPT
Can oral progesterone cause motion sickness?
All of a sudden I started getting motion sickness when riding in my husbands truck. I had terrible side effects from the progesterone that I started 7 weeks ago. I have now stopped the meds a week ago but now I get motion sickness. This is the only medication that has changed.
I’m hoping short term meclizine will help until this med gets out of my system.
I purchased over the counter meclizine. How long is it safe to take?
Hi Cheryl,
You will need to ask your doctor that question about the over the counter meclizine. I can’t advise you about medications.
I have met women who had a new onset of BPPV caused by hormone replacement therapy.
This blog may help you find a vestibular physical therapist who can assess you for BPPV.
This blog has home remedies that may help.
This is my most popular video lecture which may provide additional insight into possible causes of your discomfort.
I hope you feel better soon!
Sincerely,
Kim Bell, DPT
Is it safe to take long term if you have Meniere’s Disease?
Hi Catherine,
Unfortunately, I cannot offer specific advice for your situation since I have not evaluated you in person.
I suggest you redirect that question to your healthcare providers who have evaluated your case individually.
Best wishes,
Kim Bell, DPT
Hi I have been dizzy for 2 months and a half maybe a little more. I have been taking meclizine. My symptoms are dizziness, nausea, lightheadedness and I feel unbalanced.
Do you know what I have?
I feel like meclizine relieves the nausea but not really the dizziness and etc
Hi Walter,
I cannot speculate on what you have, but certainly BPPV assessment is a good step if you have not already.
I suggest you find a Vestibular Physical Therapist.
You can use the directories I share in this blog.
Best wishes,
Kim Bell, DPT
I have been dizzy and lightheaded for about 4 months now, along with naushea it comes and goes some days are great then other days I don’t want to get out of bed. I have an ENT she is doing PT hoping it will help with vertigo. I also have TMJ the meclizine I’m on don’t really help the dizziness is that bad? Please help me find answers.
Hi Christine,
I’m sorry to hear this!
This article may help you find a vestibular physical therapist.
This directory may help you find a manual orthopedic physical therapist.
You may need both!
I hope you feel better soon.
Best wishes,
Kim Bell, DPT
am a 61 year old male that started having vertigo 9 months ago now. I have been to my primary care physician he recommended me to an ent, the ent did some test then sent me to another type of dr that did some hearing test and eye test then a test where they send warm water into your ear with a vibrating sensation well that scent me to the ER. After that I was told I needed physical therapy, well the physical therapist tells me its not an inner ear problem. So I am stuck taking Meclizine 12.5 mg broken in 2 twice a day or I won’t be able to function. Where do I go from here? I am also suffering with Low testosterone levels 126 is my T levels. I will start treatment for that in 4 days. I am looking for advice. Can low testosterone cause vertigo? I am afraid of taking Meclizine long term because I can not get properly diagnosed
Hi Herman,
It is common for patients with vertigo to receive conflicting opinions and get the run around!
You most likely have two concurrent health issues with the vertigo and the low testosterone.
I am glad you have treatment starting for the hormone balance, as that will help you feel better overall.
I suggest for you to find a vestibular physical therapist.
This article may help you find a local provider.
This article has home remedies that may help.
Best wishes,
Kim Bell, DPT
I have Menieres disease, they don’t know what causes it. They have no cure. I alternate between meclazine & valium to stop the vertigo. I use the Valium more, because it works better for me. I just asked a Dr about dimentia caused by meclazine use & I was told he’d never heard that. I’m assuming I fall into the poor prognosis category, since nobody knows anything about Menieres.
Hi Kiki,
Patients often use meclizine short term and intermittently for vertigo episodes, without being exposed to the side effects that occur with long term continual use for years on end.
If you want to share more with your doctor, you can direct him or her to the BEERS criteria published by the American Geriatrics Society. This is a list of potentially inappropriate medications for people over 65 and lists the reasons why.
Both valium and meclizine are on that list, and it explains the reasons why.
With that said, I should advise you to take all your medications as prescribed and discuss any concerns with your doctor.
I believe the most updated version of that criteria must be purchased. It is not available for free online.
I have had dizziness since August 2021.. after seeing an ent who did a few tests recommended I see a vestibular rehab person. I have problems with balance also. Now my primary care doctor says I have b12 and iron deficiency anemia. They think that is causing my dizziness and unbalance.
Hi Linda,
Definitely abnormal lab values can contribute to dizziness and imbalance.
Typically bloodwork to check for nutritional deficiencies (or toxicities) is done at the initial visit with the primary doctor after the onset of dizziness.
I am glad that root cause was discovered in your case!
You can also have more than one root cause of dizziness.
My first bout of vertigo – it took over a week and 4 ambulance rides (that in itself is a WHOLE other horror story). The drs. didn’t really ask the right questions, I guess. Maybe because the ERs were Very busy – one night they took the IV out of my arm so they could sit me out in the waiting room – for 6 to 8 hours. Nots sure of the time, it is a little bit foggy. I was vomiting the whole time, and when I finally got in, the ER doc and nurse told me that they had done all that they could, and to suck it up and go home. If I didn’t they were going to have security escort me out.
At one point they sent me up to a floor where you can only stay for 24 or 48 hours (again, very foggy memory). Someone came in and calmly spoke to me and asked questions from before it happened to that point. She correctly “found” vertigo and I was on my way to getting better.
The biggest problem that I had at that point was that I live alone and didn’t have anyone to wake me up to take the meclezine (so I can’t spell either). I was begging for some help to set my home up so I could take care of myself, but no such help was available. I should get my neighbor with dementia to take care of me. Normally it is the other way around and she was not any help to me.
After finally speaking to someone at my family dr office, they suggested the patch that is used for seasickness. I wish that I had known about that sooner! It gave me the medication whether I was awake or not, so I didn’t miss a dose. That is what put me in a position to help myself from then on.
If anyone else is having a problem taking the seasick meds on time, definately ask for the patch. Wish I had much earlier.
Hi my question is I have dizziness problem since I was child I’m now 38 years old what can I do
Hi Abdoulaye,
You can use this article to search for a vertigo doctor in your area.
I hope you can find a local specialist to evaluate you, so you can receive a proper diagnosis and vertigo treatment plan.
Best wishes