Use and misuse of medications in the treatment of dizziness

This review discusses the pharmacological treatment of dizziness, focusing particularly on the vertigo subtype of dizziness. Classes of medications useful in the treatment of vertigo include anticholinergics, antihistamines, benzodiazepines, calcium channel blockers, and dopamine blockers. These medications often have multiple actions. They may modify the intensity of symptoms (eg, vestibular suppressants) or they may affect the underlying disease process (eg, calcium channel blockers in the case of vestibular migraine). Most of these agents, particularly those that are sedating, also have a potential to modulate the rate of compensation for damage. This consideration has become more relevant in recent years, as vestibular rehabilitation physical therapy is now often recommended in an attempt to improve compensation. Accordingly, therapy of vertigo is optimized when the prescriber has detailed knowledge of the pharmacology of medications being administered as well as the precise actions being sought.