Manning et al 3 explored the central nervous system effects of meclizine and dimenhydrate (Dramamine I). The Physicians Desk Reference lists potential adverse reactions for meclizine, noting that “Drowsiness, dry mouth and, on rare occasions, blurred vision have been reported.” But what about functional impact? Could meclizine potentially make your symptoms worse, or have other undesirable side effects? The AAO-HNS Clinical Practice Guideline for BPPV released in 2008 recommends against the use of vestibular suppressants for BPPV. BPPV does not resolve any faster, and likelihood of future episodes is not affected by meclizine. Canalith Repositioning procedures (also known as Epley maneuvers) are extremely effective in relieving the symptoms of positional vertigo. A therapeutic dosage of meclizine creates a lasting sedating effect only to minimally reduce the intensity of symptoms of benign paroxysmal positional vertigo (BPPV), which last only a few seconds. In order for maximal recovery to take place, the brain eventually must be made aware that a conflict exists, so meclizine must be withdrawn. Medication taken to suppress vestibular symptoms ideally should be used only during the acute stage following vestibular insult, typically lasting 3 to 5 days. Meclizine can help reduce this conflict and reduce vertigo and nausea. The brain would rather receive no information from the inner ears than to receive conflicting information. In acute inner ear disease (such as Vestibular Neuritis/ Labyrinthitis or a Meniere’s episode), what is making you spin and nauseous is the brain trying to resolve the conflict between a healthy ear and an unhealthy ear sending different signals to the brain. Some types of dizziness can be helped by a temporary prescription of meclizine many types won’t be affected at all, and some could be made worse. The term “dizziness” is very vague and can mean many different things. After listening to their symptoms (some of which include vertigo, nausea, or motion sickness, but just as many do not), I ask them “What is it that the meclizine is treating?” The most common answer is “the dizziness.” So many patients come into our balance clinic having received a prescription for meclizine that I am in the habit of asking them about perceived benefit. Meclizine is also packaged under the names Antivert, Bonine, and Dramamine II. For a medication that is so widely used, there is very little solid information, creating potential for confusion regarding application and potential side effects. Most patients complaining of dizziness or vertigo have been prescribed meclizine at some point. According to, the mechanism of action is described as:Īntiemetic antivertigo agent-Exhibits CNS depressant, anticholinergic, antiemetic, antispasmodic, and local anesthetic effects in addition to antihistaminic activity.ĭepresses labyrinth excitability and conduction in vestibular-cerebellar pathways.Īntiemetic and antimotion-sickness actions result, at least in part, from central anticholinergic and CNS depressant properties.īack in 2013, I did a three-part series 1 reviewing the literature regarding the use of meclizine for complaints of “dizziness.” Today’s post updates and condenses those three posts into one, with some additional new information, hoping that this shorter version might serve as a patient handout. Meclizine is an antihistamine with anticholinergic properties. The following is Alan Desmond’s Augblog at his Dizziness Depot column at.
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