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If the symptoms are very severe in an acute attack of vertigo, anti-vertigo drugs may be prescribed on a very short term basis.

There is a reluctance to prescribe medications for vertigo related to peripheral causes since the mismatched information reaching the brain from various sensory centers stimulates the central nervous system to respond by activating functions of compensation and habituation. It is important not to tamper with this natural response which explains the hesitation to use drugs for treatment.

Anti-vertigo drugs are vestibular suppressants which reduce or eliminate this compensatory mechanism. Therefore, they are used primarily when the vertigo is severe and/or is accompanied by nausea and/or vomiting. There are two types of drugs which may be used for treating vertigo:

• Vestibular Suppressants - these drugs are used to reduce symptoms of vertigo and nystagmus caused by vestibular imbalance.

  • Antihistamines: such as meclizine (Antivert) or dimenhydrinate (Dramamine). These drugs prevent motion sickness and reduce the severity of symptoms. Sedation is a common side effect.

  • Benzodiazepines - such as diazepam (Valium) or clonazepam (Klonopin). These drugs suppress vestibular responses. Side affects include addiction, impaired memory, and increased risk of falling.

  • Anticholinergics - such as amitriptyline (Elavil). These drugs increase motion tolerance and also affect compensation. Adverse effects include dry mouth, dilated pupils, and sedation.

  • Calcium channel antagonists (e.g., flunarizine, nimodipine, cinnarizine)

• Antiemetics - drugs used to control nausea in patients with vertigo which include:

  • granisetron (Kytril)
  • hydroxyzine (Atarax)
  • meclizine (Antivert)
  • dimenhydrinate (Dramamine)
  • promethazine (Phenergan)
  • prochlorperazine (Compazine)

Side effects are similar to those of vestibular suppressants since many of these medications belong to the same class of drugs.