From the Guidelines
Medication for Vertigo in Elderly Patients
For elderly patients experiencing vertigo, Meclizine is a commonly recommended medication, particularly for vertigo related to inner ear disturbances. The typical dose is 12.5 to 25 mg orally, taken 1 to 3 times daily as needed 1. However, it's essential to start with the lowest dose and monitor the patient for any adverse effects, such as drowsiness or dry mouth.
Considerations and Alternatives
- Dimenhydrinate can be considered as an alternative, but its use should be limited due to its anticholinergic side effects, which can be particularly problematic in the elderly population 1.
- In cases where vertigo is related to orthostatic hypotension, midodrine may be considered, starting at a low dose of 2.5 mg orally 3 times daily 1.
- It's crucial to assess the patient's overall health, review their current medications, and consider consulting a specialist before initiating any new medication, especially in the elderly population 1.
Key Points
- Approach treatment with caution due to potential side effects and interactions with other medications.
- Start with the lowest dose and monitor for adverse effects.
- Consider the patient's overall health and current medications before initiating new treatment.
- Consult a specialist if necessary, especially in complex cases or when the patient has multiple comorbidities.
From the FDA Drug Label
Meclizine hydrochloride tablets are indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults (1). Meclizine hydrochloride tablets are indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults.
Meclizine is indicated for the treatment of vertigo in adults, which includes elderly patients. The recommended dosage is 25 mg to 100 mg daily, in divided doses 2.
From the Research
Medication for Vertigo in Elderly Patients
The provided studies do not specifically mention a particular medication indicated for vertigo in elderly patients. However, they discuss the importance of identifying the underlying cause of vertigo and considering the patient's comorbidities and potential drug interactions when choosing a treatment.
Causes of Vertigo in Elderly Patients
- Audio-vestibular disorders are the most common cause of vertigo in elderly patients, accounting for 28.4% of cases 3
- Cardiovascular diseases are the second most common cause, accounting for 20.4% of cases 3
- Neurological diseases are the third most common cause, accounting for 15.1% of cases 3
- Other causes of vertigo in elderly patients include psychiatric conditions, ophthalmologic disorders, musculoskeletal disorders, medication adverse effects, and metabolic-related diseases 3
Treatment Approach
- A systematic and planned approach is recommended for treating dizziness in elderly patients, considering the possibility of multiple contributing causes 4
- Vestibular and physical rehabilitation are strongly advised and rarely contraindicated in patients with vertigo 5
- A multidisciplinary strategy, involving different specialists, is recommended for the correct assessment and treatment of vertigo in elderly patients 3