![]() 8 Scopolamine has been shown to be more effective than meclizine in treating the symptoms of motion sickness. In 1972 a randomized, double-blind crossover study indicated that meclizine had a greater effect than a placebo on diminishing symptoms and signs of vertigo of vestibular origin. However, since suppressant medications may hinder the function of the vestibular apparatus at a time when the patient is most dependent upon it, these patients actually may experience greater symptoms. Many patients describing dizziness do not experience vertigo and may have perfectly normal vestibular function. However, this is a less than ideal treatment for two reasons: a therapeutic dosage of Antivert creates a lasting sedating effect only to marginally reduce the intensity of symptoms, which last only a few seconds, and Canalith repositioning procedures are extremely effective in relieving the symptoms of positional vertigo. The intensity of vertigo associated with BPPV may be lessened when using Antivert. Appropriate treatment following the acute phase encourages activity to promote central compensation rather than suppression of stimulation needed for compensation. In order for natural or therapeutically enhanced compensation to take place, the brain eventually must be made aware that an asymmetry exists. Tonic asymmetry in activity in these areas creates the acute symptoms of vestibular-induced vertigo. ![]() During the acute phase of vestibular dysfunction, typically lasting three to five days, vestibular suppressants are helpful in reducing the activity in the vestibular nuclei and cerebellum. Medication taken to suppress vestibular symptoms ideally should be used only during the acute stage following vestibular insult. According to the Physicians’ Desk Reference, it is effective for “management of vertigo associated with diseases affecting the vestibular system.” 7 Antivert is not recommended for complaints of unsteadiness, disequilibrium, loss of balance, or pre-syncopal lightheadedness. Although etiology of these complaints was not obtained, we know that BPPV is the most common cause of vertigo, and disequilibrium and unsteadiness can be the result of vestibular and/or non-vestibular pathology.Īntivert (meclizine hydrochloride) is an antihistamine. 6 On further questioning, approximately 75 percent described their dizziness as unsteadiness, disequilibrium, loss of balance, or pre-syncopal lightheadedness. A recent study reports that of elderly patients complaining of dizziness, only 25 percent were describing rotary vertigo. 5ĭizziness is a vague term that can mean different things to different people. 4 However, another study found that in the general population only 31 percent of patients receiving medication for dizziness found it helpful. ![]() In one study, approximately 90 percent of patients subsequently diagnosed with benign paroxysmal positional vertigo (BPPV) were given Antivert prior to receiving a correct diagnosis. Well over half of these patients – 61 percent to 89 percent – receive some type of medication following their initial visit, Antivert being the most common. While there is general agreement among specialists that vestibular compensation is inhibited by the use of vestibular or central nervous system sedative medications, 1 the literature suggests that these types of medications are used the majority of the time when a patient presents in the primary care setting with the complaint of dizziness, vertigo or imbalance. Brian Collie, D.O., R.Ph.Ĭonsidering how frequently Antivert is prescribed for dizziness, its effectiveness has been measured in remarkably few studies. Research indicates that long-term use may not be the best solutionīy Alan L.
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