Vertigo is a condition in which the patient experiences the illusion of motion and suffers from symptoms such as "feeling that the world is spinning," dizziness, nausea and vomiting. Vertigo can cause difficulty with standing or walking. Medications are used to treat vertigo that lasts from a few hours to a few days. If the vertigo persists any longer, further evaluation is usually undertaken so the underlying cause can be treated.
Meclizine
Meclizine, a medication most commonly used to treat nausea and vomiting, can also relieve the dizziness of vertigo. Side effects include drowsiness and exacerbation of preexisting asthma or glaucoma.
Dimenhydrinate
This medication belongs to a class known as antihistamines, and its use usually gives relief from vertigo and associated nausea. However, its method of action is still poorly understood. Side effects include drowsiness, blurred vision and dry mouth.
Diazepam
Diazepam is a type of drug known as a benzodiazepine, which acts as a sedative. It depresses all levels of the nervous system, which helps with acute episodes of vertigo. Usually benzodiazepines are discontinued due to side effects such as excessive sedation, confusion, decreased inhibitions and the the drugs' addictive qualities.
Metoclopramide
Metoclopramide is primarily used to treat the vomiting vertigo can cause. It doesn’t have substantial effects on the dizziness and other symptoms of vertigo, so it is usually used as an adjunct or second-line therapy. Side effects include motion disorders, fluid discharge from nipples, diarrhea and depression.
Prochlorperazine
Prochlorperazine belongs to the class known as phenothiazines, which are usually used as antipsychotics. It has considerable effectiveness treating the symptoms of vertigo, as well as nausea and vomiting in general. Side effects include abnormal facial or body movements and a dangerous condition called “neuroleptic malignant syndrome.” This includes confusion, irregular blood pressure, fast heart rate and disturbances in cardiac rhythm.
Promethazine
Promethazine is also a phenothiazine, but its antihistamine effects are stronger than those of any other antihistamine in preventing vertigo. Side effects include excessive sedation, dry mouth, seizures, neuroleptic malignant syndrome and decreased respiratory function (especially in those under the age of 2).
References
- "American Family Physician;" Treatment of Vertigo; R. Swartz & P. Longwell; Volume 71, Issue 6 (March 2005)
- “Neurology in Clinical Practice, 5th Edition;” W.J. Bradley et al.; 2008
- "Emergency Medicine Clinics of North America;" Vertigo and Dizziness in the Emergency Department; K. Kerber; Volume 27, Issue 1 (February 2009)
