From the FDA Drug Label
The data cited in the two tables below are estimates of untoward clinical event incidence among patients who participated under the following clinical conditions: ... These figures cannot be compared with those obtained from other clinical studies involving related drug products and placebo as each group of drug trials are conducted under a different set of conditions ... Treatment-Emergent Adverse Events Reported in Placebo-Controlled Trials of Anxiety Disorders ... Dizziness1.80.82.5 Treatment-Emergent Adverse Events Reported in Placebo-Controlled Trials of Panic Disorders ... Light-headedness/Dizziness29.836.9
- Key findings:
- Dizziness is reported as an adverse event in both anxiety disorders and panic disorders trials.
- The incidence of dizziness is 1.8% in anxiety disorders trials and 29.8% in panic disorders trials.
- Clinical decision: Alprazolam (Xanax) may worsen dizziness and vertigo, as dizziness is a reported adverse event in clinical trials, especially in patients with panic disorders 1.
From the Research
Alprazolam and Dizziness/Vertigo
- Alprazolam, a benzodiazepine, is used to treat anxiety disorders, including those that may co-exist with vestibular symptoms like dizziness and vertigo 2.
- While alprazolam can be effective in relieving anxiety symptoms, it may also produce adverse effects such as drowsiness and sedation, which can potentially worsen dizziness and vertigo 3.
- A study comparing alprazolam and lorazepam in the treatment of anxiety found that alprazolam was associated with less dizziness at week 4, suggesting that it may not necessarily worsen dizziness in all cases 4.
- However, another study found that benzodiazepines, including alprazolam, can be used to treat psychogenic vertigo, which is vertigo associated with anxiety disorders, suggesting that alprazolam may have a role in treating vertigo in certain contexts 5.
Vestibular Suppressants and Alprazolam
- Benzodiazepines, including alprazolam, are classified as vestibular suppressants, which can be used to treat vertigo and other vestibular disorders 5.
- However, the use of vestibular suppressants like alprazolam can also have negative effects on the compensation process for vestibular damage, highlighting the need for careful consideration in their use 5.
- Other medications, such as clonazepam, have been found to be effective in treating vertigo and tinnitus, with a relatively low incidence of adverse side effects 6.
Clinical Considerations
- The treatment of vertigo and dizziness should be tailored to the underlying cause, with consideration of the potential benefits and risks of different medications, including alprazolam 5, 2.
- Clinicians should be aware of the potential for alprazolam to worsen dizziness and vertigo in some cases, and monitor patients closely for adverse effects 3, 4.