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

Certain cases in which long term use of Meclizine is appropriate are those where the root cause evaluation has been completed by a Vestibular Expert and a poor prognosis for recovery is determined. If the chance of recovery is not favorable, then long term use of vestibular suppressants can help to minimize discomfort and improve quality of life.But the literature and research is clear that long term use of Meclizine for vertigo symptoms is appropriate only for cases with a poor prognosis for recovery.

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.

This blog is for informational purposes only. The content is 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 I might see and do not describe the circumstances of a specific individual.