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Vertigo Treatments and Medications

Medically reviewed by Anis Rehman, MD
Physician
Updated Jul. 26, 2023  •  Published Jun. 17, 2020
Fact Checked

Vertigo is a feeling of dizziness with a spinning or rocking sensation. It is often accompanied by lightheadedness or feeling off-balance. Common causes of vertigo are typically due to problems in the inner ear and less commonly, problems in the brain. Knowing the cause of your vertigo is the first step in determining what home treatments and medications you can use to help treat your vertigo. Let’s take a more in-depth look at vertigo to find the best options to help your symptoms.

What is vertigo?

Vertigo is the dizziness characterized by a feeling of movement: either spinning or swaying. During a vertigo attack, you may also feel light-headed or off-balance. The most common symptoms of vertigo include:

  • Dysequilibrium, or difficulty keeping your balance
  • Feelings of spinning/swaying or being pulled in one direction
  • Feelings of pressure or fullness in the inner ear
  • Difficulty walking
  • Headache
  • Tinnitus or ringing in the ear
  • Nausea
  • Vomiting
  • Hearing loss
  • Nystagmus or abnormal eye movements

Treatment for vertigo depends on the underlying cause. Some causes of vertigo will clear up on their own, such as those from standing up too quickly or a head injury. The most common cause of vertigo is an inner ear infection, which may require antibiotics to treat the infection. Benzodiazepine drugs, or drugs that calm the central nervous system, are used for people with vertigo caused by vestibular disorders, or problems in the inner ear and brain. One vestibular disorder is Meniere’s disease, which is an inner ear disorder characterized by vertigo and hearing loss. In some cases, such as with benign paroxysmal positional vertigo (BPPV), a simple head movement treats the disorder. This helps clear the calcium build up in the inner ear which causes BPPV and can help relieve vertigo. In some more serious cases, inner ear surgery may be required for BPPV. Physical therapy may also benefit those who suffer from long term vertigo symptoms.

How is vertigo diagnosed?

Vertigo is diagnosed by a doctor and since there are many underlying conditions that cause vertigo there are a variety of questions and tests that your doctor may perform to diagnose the cause of vertigo. Be prepared for questions from your doctor such as:

  • What medications are you currently taking? The doctor will likely ask for a list of current medications since dizziness is a common side effect with many medications.
  • What type of dizziness are you experience? Vertigo that feels like being on a merry-go-round is found in disorders such as vestibular neuritis (inflammation of the vestibular nerve). However, dizziness that feels like being on a boat is found in bilateral vestibulopathy (damage in both inner ears). Dizziness without the sensation of movement is not considered vertigo.
  • How long does your vertigo last? Shorter vertigo attacks (that last for seconds or minutes) indicate vestibular paroxysmia (compression of the vestibulocochlear nerve), while vertigo attacks lasting hours may indicate Meniere’s disease or vestibular migraine (migraines with vertigo). Attacks lasting days or weeks are more common with conditions such as vestibular neuritis. Vertigo with certain head movements lasting a few minutes to a few hours could indicate mini-strokes.
  • What triggers your vertigo attacks? If you get vertigo attacks while at rest, this could be a cause of vestibular neuritis, while attacks triggered by walking could be a sign of bilateral vestibular paroxysm. If vertigo is triggered while turning while laying down, this is more common in BPPV.
  • What other symptoms are you experiencing? Other symptoms caused by inner ear problems include tinnitus, difficulty hearing, or pressure in the ears. While symptoms like double vision, difficulty swallowing, or paralysis in the arms or legs may indicate issues in the brain or central nervous system. Headaches or migraines are symptoms that may indicate vestibular migraines.

These questions will likely be asked by your primary care physician. However, if more extensive testing is needed and an inner ear condition is suspected your doctor will likely send you to an otolaryngologist or if a brain disorder is suspected they may send you to a neurologist or neurosurgeon for more medical advice. When seeing the specialty doctors, there are a few tests they may run depending on your symptoms, these include:

  • Routine tests: Blood pressure, blood sugar levels, and oxygen level tests will be reviewed to ensure these areas are not causing dizziness.
  • Test of balance and gait: A Romberg test, in which a person stands with their feet close together and then closes their eyes, is a test of balance your doctor may perform. Your doctor also may have you try to walk in a straight line.
  • Hearing test: If you or your doctor notices a change in hearing abilities, your doctor may send you for a formal hearing test with an audiologist.
  • Rotary chair testing: This test checks for abnormal eye movements while the patient is rotated in a chair.
  • Dix-Hallpike maneuver: This test, also known as the head-hanging test, is the recommended test of the American Academy of Otolaryngology—Head and Neck Surgery to confirm the presence of BPPV.
  • Brain imaging: An MRI (magnetic resonance imaging) may be used in patients with neurological causes of vertigo. A CT (computed tomography) scan might be ordered, but it’s typically less preferred than an MRI.
  • Specialized tests: In some cases, more specialized tests such as electronystagmography (ENG) and videonystagmography (VNG) may be ordered by a physician.

During these tests, it is important to ask your doctor any questions you may have about your vertigo. These questions may include:

  • What condition is causing my vertigo?
  • Is there anything triggering my vertigo? What triggers should I avoid?
  • Is my condition temporary or permanent?
  • What treatment options do I have?
  • How long will my treatment last?
  • What should I expect during treatment? What are the risk factors?
  • What outcomes can I expect from treatment? Will there be side effects?
  • Do I need to take any precautions while experience vertigo? (i.e., is it still safe to drive?)

What are vertigo treatment options?

Vertigo varies depending on the underlying cause of vertigo. Some cases of vertigo will resolve on their own since the brain is able to adapt to changes in the inner ear. However, for moderate to severe vertigo there are three common treatments:

  • Physical therapy/repositioning maneuvers: Some physical therapists are trained in vestibular rehabilitation, which helps strengthen the vestibular system to improve vertigo. They can also teach you ways to move around safely despite vertigo. There are also head movements helpful to those with BPPV, which helps clear calcium the ear canal.
  • Medication: A doctor may switch your current medications if they are the cause of vertigo. Medications to help vertigo, will either treat the underlying cause of the vertigo or help suppress the symptoms of vertigo caused by a recurring condition. For causes like Meniere’s disease, vestibular suppressants are used. These medications may include benzodiazepines, which work by suppressing the nervous system. Vertigo associated with migraines is often treated with benzodiazepines, antiemetics, and antihistamines. It can be prevented with either antidepressants or calcium channel antagonists, which prevent constriction in the arteries.
  • Surgery: Rare causes of vertigo, such as those caused by tumor or brainstem injury, may require surgery.

What medications treat vertigo?

There are a variety of drugs that may be prescribed to treat vertigo. These medications include:

  • Antihistamines, such as Antivert (meclizine) or Phenergan (promethazine), may be prescribed to treat nausea and vomiting associated with vertigo. These decrease the feelings of motion sickness associated with vertigo. Antihistamines can sometimes cause drowsiness.
  • Benzodiazepines, such as Valium (diazepam) or Ativan (lorazepam), often relieve vertigo caused by inner ear disorders such as Meniere’s disease, labyrinthitis, migraine-associated vertigo, or vestibular neuronitis. These drugs relieve vertigo by suppressing the vestibular system. These drugs are typically given in small doses to avoid addiction to the medication. These drugs also have a side effect of drowsiness.
  • Diuretics, or water pills—such as Dyazide (triamterene/HCTZ), Lasix (furosemide), or acetazolamide—are often prescribed to those with Meniere’s disease. Diuretics help remove inner ear fluid that can cause vertigo. Side effects of diuretics can include dehydration and frequent urination.
  • Corticosteroids, such as Decadron (dexamethasone) or oral prednisone, have been found to decrease the length and frequency of vertigo in those with Meniere’s disease. These drugs should be used for a short time, otherwise, you can become steroid-dependent and develop adrenal insufficiency.

What is the best medication for vertigo?

Discuss with your doctor the best medication for your vertigo. The best medication will depend on your medical condition, medical history, and medications you are currently taking that may interact with vertigo medication as well as your response to the treatment. Here is a list of the most commonly prescribed medications:

Best medications for vertigo
Name Drug class Administration route Standard dosage How it works Most common side effects
Dramamine Less Drowsy (meclizine) Antihistamines Oral 25 mg tablet Treats and prevents dizziness, nausea, and vomiting caused by motion sickness Headache, vomiting, dry mouth
Phenergan (promethazine) Antihistamines Oral or Suppository 25 mg every 4-6 hours as needed Treats and prevents dizziness, nausea, and vomiting caused by motion sickness Drowsiness, dizziness. Do not use for children under 2 due to fatal respiratory distress.
Valium (diazepam) Benzodiazepines Oral 2 mg tablet twice a day Suppress vestibular responses Addiction, impaired memory, increased risk of falling
Ativan (lorazepam) Benzodiazepines Oral 0.5 mg tablet twice a day Suppress vestibular responses Addiction, impaired memory, increased risk of falling
Dyazide (triamterene/HCTZ) Diuretic Oral 25-75 mg tablet once a day Decreases fluid in inner ear Dizziness, lightheadedness
Decadron (dexamethasone) Corticosteroids Oral 0.75-9 mg tablet Steroids reduce swelling Aggression, agitation, anxiety
Prednisone Corticosteroids Oral 0.35 mg tablet per day Steroids reduce swelling Sleep problems, increased appetite, acne

Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.

What are the common side effects of vertigo medication?

Side effects vary depending on the medication given to treat vertigo. Be sure to tell your doctor any medications you may be allergic to before taking a new medication. Some common side effects of vertigo medication are drowsiness, headache, nausea, vomiting, dizziness, and lightheadedness. Be sure to discuss any other possible side effects with your doctor at your appointment. Immediately talk to your doctor if you have signs of allergic reactions such as hives, difficulty breathing, or swelling of the mouth and throat.

What are the best home remedies for vertigo?

There are home remedies that may help prevent episodes of vertigo or help those suffering from vertigo cope in daily life. These home remedies include:

  • Exercises and physical therapy can help strengthen muscles and help you walk independently longer. Vestibular rehabilitation therapy is a type of specialized physical therapy that can help with symptoms of vestibular dysfunction.
  • Changes around the home, such as storing items in places easier to reach and limiting bending down or looking up will help decrease some triggers for vertigo.
  • The Epley maneuver, also known as the canalith repositioning procedure, is an at-home exercise that treats BPPV. An otolaryngologist can teach you during the office or there are videos and instructions can be found online.
  • The Semont-Toupet maneuver is another exercise that can be performed at home and has been found to be as effective as the Epley maneuver.
  • The Brandt-Daroff exercise, while initially causes increased dizziness, can help decrease symptoms of vertigo and can be performed at home.
  • The Chinese herb Ginkgo biloba was found in a double-blind study to improve symptoms of vertigo.
  • Eating almonds and ginger root are both said to help with vertigo symptoms.
  • Staying hydrated is important for those taking diuretics since a common side effect is dehydration.
  • Peppermint, lemon, and lavender essential oils may help with side effects caused by vertigo, such as nausea, vomiting, and headaches.
  • Cutting out alcohol can help improve inner ear fluid levels. Alcohol can also increase dehydration.
  • Getting enough sleep is important because a lack of sleep can increase symptoms of vertigo.

Frequently asked questions about vertigo

What triggers vertigo attacks?

Vertigo is usually triggered by an underlying condition. Vertigo is commonly associated with an inner ear infection, while other times they are from different disorders such as BPPV or Meniere’s disease. Vertigo can also be triggered by certain head or body movements.

How do you stop vertigo?

Some cases of vertigo will clear up on their own. However, other cases will require treatment from a doctor. There are also home remedies that may improve and stop vertigo.

How long can vertigo last?

Vertigo as a result of inner ear infection/inflammation may last a few days. While vertigo from Meniere’s disease can last anywhere from 20 minutes to 24 hours. Occasionally people may experience vertigo for several months.

Is vertigo curable?

Vertigo is curable in many cases depending on the underlying condition. However, there are medications and home remedies that can help improve the frequency and duration of vertigo.

Who is the most qualified to treat vertigo?

Some cases of vertigo can be treated by a family physician or general practitioner. However, if a patient needs more specialized treatment, they may require an otolaryngologist, head and neck surgeon, neurosurgeon, or neurologist.

Does Dramamine help vertigo?

Dramamine is an option for vertigo that is associated with nausea, vomiting, and feeling of motion sickness.

Does Benadryl help vertigo?

Benadryl does help some cases of vertigo and may be recommended by your physician.

Medically reviewed by Anis Rehman, MD
Physician

Dr. Anis Rehman is an American Board of Internal Medicine (ABIM) certified physician in Internal Medicine as well as Endocrinology, Diabetes, and Metabolism who practices in Illinois. He completed his residency at Cleveland Clinic Akron General and fellowship training at University of Cincinnati in Ohio. Dr. Rehman has several dozen research publications in reputable journals and conferences. He also enjoys traveling and landscape photography. Dr. Rehman frequently writes medical blogs for District Endocrine (districtendocrine.com) and hosts an endocrine YouTube channel, District Endocrine.

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