Your guide to medications for vertigo

Key takeaways

• Several medications, including benzodiazepines and antihistamines, can be used to manage vertigo symptoms, but they may have certain side effects or interactions with other medications.
• Medications like diazepam, lorazepam, meclizine, and promethazine can help manage vertigo by calming brain activity or preventing signals that cause dizziness, nausea, and vomiting.
• Consulting a doctor is essential to determine the most appropriate vertigo medication based on individual needs and to monitor for potential side effects or interactions with other drugs.

Overview

Vertigo is a distinct form of dizziness. When you have vertigo, you might have the sensation of that you’re spinning.

Vertigo is often the result of a condition known as benign paroxysmal positional vertigo (BPPV). This is where calcium crystals located in the inner ear become loose, resulting in a spinning sensation whenever your head changes position. However, there are other forms of vertigo.

Several other health conditions can result in vertigo, such as strokes and medication side effects.

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Medications to manage vertigo

Generally, vertigo is managed with measures like repositioning maneuvers, or even surgery in some cases. However, once a doctor has evaluated your condition and determined the cause, they may prescribe medications to manage vertigo.

Antihistamines

Antihistamines are medications that can manage conditions associated with the release of histamine. Specifically, some antihistamines can be used to prevent or manage symptoms of motion sickness, including dizziness, nausea, and vomiting. This may also help with vertigo symptoms.

Some of these drugs, such as meclizine (Antivert), can prevent signaling in the brain that causes dizziness. Others, such as promethazine (Phenergan), act on some of the brain’s dopamine and alpha-adrenergic receptors to reduce symptoms.

According to some 2022 research, antihistamines may be more effective than alternatives like benzodiazepines at reducing vertigo symptoms. Antihistamines are also commonly available over the counter (OTC), so they’re considered safe and effective.

Common side effects you might experience with these drugs include:

• drowsiness
• fatigue
• dry mouth
• nausea or vomiting
• blurred or double vision
• ringing in the ears
• loss of coordination
• itching
• unusually happy mood

Benzodiazepines

A class of medications called benzodiazepines may be used to manage vertigo. They generally aren’t approved by the Food and Drug Administration to manage vertigo, but they can be prescribed off-label for this use.

Benzodiazepines work by calming overactivity in the brain and can help treat various conditions such as anxiety, muscle spasms, and seizures. These medications may also work for short-term symptoms management of vertigo.

For example, diazepam (Valium) is in the benzodiazepine class of medications. Diazepam can effectively treat vertigo symptoms during acute episodes. It’s available as a tablet, solution, or concentrate. You take it orally with or without food.

A doctor might prescribe a different benzodiazepine medication to treat vertigo, called lorazepam (Ativan). It works similarly to diazepam.

Some older 2017 research suggests that benzodiazepines like diazepam are as effective as antihistamines to manage vertigo. However, more recent research from 2022 suggests that benzodiazepines may not be as effective at managing vertigo as alternatives like antihistamines.

Like with all medications, diazepam may cause side effects. These include:

• drowsiness
• dizziness 
• fatigue (low energy)
• muscle weakness
• dry mouth
• nausea
• constipation

Benzodiazepines can also cause serious side effects. You should get medical help immediately if you experience any of the following:

• uncontrollable shaking
• slurred speech
• slowed heart rate
• slowed breathing
• loss of body movements

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How to choose the right vertigo medication 

It can be helpful to discuss your medication options with a doctor. Some factors to consider are:

• Other medications you’re taking: Some medications may interact with others you’re taking. For example, benzodiazepines should never be taken alongside opioid pain relievers. Discuss your medication history with a doctor before they prescribe you anything new.
• Potential side effects: Some drug options, such as diazepam, might also be habit-forming or can lead to dependence. Ask your doctor about possible side effects before taking a new medication.
• Condition causing your vertigo: Some vertigo symptoms include ringing in the ears (tinnitus) and hearing loss. Depending on your symptoms and the cause of your symptoms, some medications like meclizine might be particularly effective.
• Timing and form of dosage: You may prefer to take a medication in a specific form, such as a tablet or liquid, and at a frequency that suits you. 

You might also want to discuss changing your medication with a doctor if your current medication is not effective or has unwanted side effects.

Summary

Several medications are available to treat vertigo.

These typically include benzodiazepines and antihistamines. But it’s important to know that some of these medications can cause serious side effects, and you shouldn’t take them with other drugs. 

Consider discussing the symptoms you’re experiencing with a doctor. They can help identify the best treatment options specific to your needs.

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