Dizziness triggered by anxiety is commonly treated with anti-anxiety or antipsychotic medications, or antihistamines. Anxiety causes the adrenal glands to secrete an excess amount of the stress hormones adrenaline, noradrenaline and cortisol, which in turn increases heart beat, respiration and muscle energy. Beta blockers, which are commonly prescribed for anxiety, prevent stress hormones from binding at their natural binding sites. This relieves the symptoms of anxiety. However, beta blockers may also cause blood pressure to drop, which can cause dizziness.
Benzodiazepines
Drugs in the benzodiazepine class are strong sedatives with anxiolytic, or anti-anxiety, effects. The most frequently prescribed drugs in this class are diazepam, or Valium, and alprazolam, or Xanax. Benzodiazepines enhance the potency of the brain's main inhibitory neurotransmitter GABA by binding to the GABA receptor. Stimulation at this receptor decreases the release of neurotransmitters, which slows down neuron activity in the brain. As benzodiazepines may cause dizziness at higher doses, only low doses should be used to treat anxiety associated with dizziness.
Serotonine Reuptake Inhibitors
Selective serotonin reuptake inhibitors, or SSRIs, are among the most commonly prescribed anti-anxiety medications. SSRIs prevent serotonin in the brain from being transported back into brain cells. The increased amounts of serotonin down-regulate fear processing in the amygdala, a small structure in the brain's limbic system.
Serotonin-norepinephrine reuptake inhibitors, or SNRIs, are a newer class of anti-anxiety and antidepressant drugs that inhibit the reuptake of serotonin and norepinephrine. Increased amounts of norepinephrine in the brain have a positive effect on energy levels and may enhance the action of serotonin. According to a meta-analytical study published in the March 2001 issue of "British Medical Bulletin," SNRIs have more potent anxiolytic properties than SSRIs, fewer side effects and a quicker onset of action.
Buspirone
According to a study published in a May 2007 issue of "Drug Metabolism & Disposition," buspirone is a serotonin partial agonist that acts specifically on the 5-GT1A serotonin receptor after being transformed into 6-OH-buspirone. Stimulation of the serotonin receptor triggers an increase in serotonin and a decrease in fear computation in the amygdala and secretion of stress hormones from the adrenal glands. Buspirone is officially proved for the treatment of generalized anxiety disorder. As its onset of action is slow, it is not suitable for short-term treatment of anxiety.
Prochlorperazine
Prochlorperazine is a dopamine antagonist prescribed for the treatment of schizophrenia, vertigo, dizziness, vomiting and nausea. It binds to dopamine D2 receptors in the central nervous system and may also have some affinity for the anti-histamine receptor H1. As a dopamine antagonist, prochlorperazine prevents available dopamine from binding to its natural binding sites. This has a semi-paralyzing and calming effect. According to a study published in the February 2009 issue of "The American Journal of Emergency Medicine," prochlorperazine is effective in pain management and in the short-term treatment of anxiety disorders.
Antihistamines
A wide range of antihistamines are used to treat dizziness, nausea and vomiting, including dimenhydrinate, meclizine and promethazine. Histamine is a naturally occurring chemical secreted by the immune system's mast cells and basophils in response to "foreign invaders." A histamine release can give rise to an allergic response as well as anxiety, according to a review published in the July 2005 issue of "Drug Development research." Antihistamines are drugs that block the effects of histamine. Dimenhydrinate, meclizine and promethazine competitively block the H1 histamine receptor and has some affinity for the dopamine receptors. By binding to histamine receptors in the vestibular system of the brain, antihistamines can relieve symptoms of motion sickness. As antihistamines have a sedative effect, they are occasionally used to treat insomnia and anxiety.
References
- "Psychopharmacology: The Fourth Generation of Progress"; The Pharmacotherapy of Acute Anxiety
- "British Medical Bulletin"; Meta-Analytical Studies on New Antidepressants; Ian M. Anderson; March 2001
- "Drug Metabolism & Disposition"; 6-Hydroxybuspirone Is a Major Active Metabolite of Buspirone: Assessment of Pharmacokinetics and 5-Hydroxytryptamine1A Receptor Occupancy in Rats; Harvey Wong, et al.; May 2007
- "The American Journal of Emergency Medicine"; Randomized Evaluation of Octreotide Vs Prochlorperazine for ED Treatment of Migraine Headache; Michael A. Miller, et al.; February 2009
- "Drug Development Research"; Histamine Receptors as Potential Therapeutic Targets to Treat Anxiety and Depression; Jacob Raber; July 2005
