From the Guidelines
Treatment for vertigo should prioritize the use of canalith repositioning procedures, such as the Epley maneuver, for patients with posterior canal Benign Paroxysmal Positional Vertigo (BPPV), as recommended by the strongest and most recent evidence 1. The treatment options for vertigo depend on the underlying cause, which can include inner ear disorders, vestibular neuritis, migraines, or central nervous system issues.
- For Benign Paroxysmal Positional Vertigo (BPPV), the Epley maneuver or canalith repositioning procedure is highly effective and recommended as the initial treatment 1.
- Vestibular rehabilitation therapy may also be offered as an option for the treatment of BPPV, either self-administered or with a clinician 1.
- Lifestyle modifications, such as avoiding sudden head movements and rising slowly from lying or sitting positions, can help manage symptoms.
- In some cases, medications like dimenhydrinate (Dramamine) or meclizine (Antivert) may be used for immediate relief, but vestibular suppressant medications are not recommended for routine treatment of BPPV 1.
- Patient education is crucial, including discussions about the impact of BPPV on daily life, the risk of falls, and the importance of follow-up 1.
- For persistent BPPV, repeat repositioning maneuvers can be performed, with a high success rate of 90 to 98 percent 1.
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). Recommended dosage: 25 mg to 100 mg daily, in divided doses (2.1).
The treatment option for vertigo is meclizine hydrochloride tablets, with a recommended dosage of 25 mg to 100 mg daily, in divided doses.
- The dosage can be administered as tablets, which should be swallowed whole.
- Key considerations for treatment include potential drowsiness and anticholinergic action, which may impact patients with certain medical conditions, such as asthma, glaucoma, or enlargement of the prostate gland 2.
From the Research
Treatment Options for Vertigo
The treatment options for vertigo can be categorized into different types, including:
- Pharmacological treatment: This includes the use of medications such as anticholinergics, antihistamines, benzodiazepines, calcium channel antagonists, and dopamine receptor antagonists to manage vertigo symptoms 3.
- Physical therapy: Vestibular rehabilitation physical therapy is often recommended to promote compensation for vestibular damage 3.
- Canalith repositioning maneuvers: The Epley maneuver is a commonly used treatment for benign paroxysmal positional vertigo (BPPV) 4, 5.
- Betahistine therapy: Betahistine has been shown to be effective in the treatment of BPPV, particularly when used in combination with the Epley maneuver 4, 5.
Specific Treatment Regimens
Different treatment regimens can be tailored to specific causes of vertigo, including:
- Otological vertigo: Treatment options include vestibular suppressants, salt restriction, and diuretics for Ménière's disease, and brief use of vestibular suppressants for vestibular neuritis 3.
- Central vertigo: Prophylactic agents such as L-channel calcium channel antagonists, tricyclic antidepressants, and beta-blockers are used to treat migraine-associated vertigo 3.
- Psychogenic vertigo: Benzodiazepines are the most useful agents in treating psychogenic vertigo 3.
- BPPV: The Epley maneuver is the most effective treatment method, with or without the addition of betahistine or dimenhydrinate therapy 4, 5, 6.
Effectiveness of Treatment Options
Studies have shown that: