From the Guidelines
Regan (Reglan) is not recommended for the treatment of vertigo, as there is no evidence to suggest its effectiveness in this context. The most recent and highest quality study, published in 2017 1, found that vestibular suppressant medications, including Reglan, are not effective as a definitive, primary treatment for benign paroxysmal positional vertigo (BPPV) and may even cause significant harm, such as drowsiness, cognitive deficits, and increased risk of falls.
Key Points to Consider
- The study compared various treatments, including diazepam, lorazepam, and placebo, and found that all groups showed a gradual decline in symptoms with no additional relief in the drug treatment arms 1.
- Particle repositioning maneuvers were found to have substantially higher treatment responses (78.6%-93.3% improvement) compared with medication alone (30.8% improvement) at 2-week follow-up 1.
- The addition of an antihistamine to canal repositioning maneuvers demonstrated no change in the Dizziness Handicap Inventory score, suggesting that vestibular suppressant medications may not provide significant benefits in treating vertigo 1.
Alternative Treatments
- Canal repositioning maneuvers, such as the Epley maneuver, have been shown to be effective in treating BPPV and are recommended as the primary treatment 1.
- Vestibular training and education on modifying a practitioner's use of vestibular suppressant medications can also be beneficial in reducing the risk of falls and improving outcomes for patients with vertigo 1.
From the Research
Treatment of Vertigo
- The provided studies do not mention Reglan (Metoclopramide) as a treatment for vertigo 2, 3, 4, 5, 6.
- The studies focus on the treatment of Benign Paroxysmal Positional Vertigo (BPPV) using Epley's maneuver and other physical therapy techniques 2, 3, 4, 5, 6.
- Epley's maneuver is shown to be an effective treatment for BPPV, with a high success rate in resolving symptoms and converting a positive Dix-Hallpike test to negative 3, 4, 5.
- The use of medications such as benzodiazepines, antihistamines, and anticholinergic medications is also mentioned, but their effectiveness is questioned 6.
- There is no evidence to suggest that Reglan (Metoclopramide) is used to treat vertigo in the provided studies 2, 3, 4, 5, 6.
Epley's Maneuver
- Epley's maneuver is a physical therapy technique used to treat BPPV by relocating free floating particles from the affected semi-circular canals back into the utricle 3, 4, 5, 6.
- The maneuver is shown to be safe and effective in resolving symptoms of vertigo and converting a positive Dix-Hallpike test to negative 3, 4, 5.
- The studies suggest that Epley's maneuver is a better treatment option for BPPV compared to conventional drug therapy alone 3, 6.