From the Research
Medications that can cause nystagmus include anticonvulsants, sedatives, central nervous system depressants, lithium, certain antipsychotics, and some aminoglycoside antibiotics, as they can disrupt the neural pathways controlling eye movements. The most common culprits are:
- Anticonvulsants such as phenytoin (Dilantin), carbamazepine (Tegretol), and valproic acid (Depakote), especially when blood levels exceed therapeutic ranges 1
- Sedatives and central nervous system depressants like benzodiazepines (diazepam, lorazepam), barbiturates, and alcohol 2
- Other medications that may cause this side effect include lithium, certain antipsychotics, phencyclidine (PCP), ketamine, and some aminoglycoside antibiotics like gentamicin which can affect the vestibular system 3
- Stimulants such as cocaine, amphetamines, and MDMA may induce nystagmus through their effects on neurotransmitters in the brain 4 The mechanism typically involves disruption of the neural pathways controlling eye movements, either through effects on the cerebellum, brainstem, or vestibular system 5. If medication-induced nystagmus occurs, it should be reported to a healthcare provider as it may indicate toxicity or an adverse reaction requiring dose adjustment or medication change. Some medications can be used to treat nystagmus, such as:
- 4-aminopyridine and 3,4-diaminopyridine for downbeat nystagmus 1
- Baclofen for periodic alternating nystagmus 1
- Gabapentin and memantine for acquired pendular nystagmus 3 However, the treatment of nystagmus depends on the characteristics of the nystagmus and the severity of the associated visual symptoms, and the choice of treatment should be individualized.