Healthcare providers sometimes prescribe allergy and anxiety medications as “vestibular suppressants” to treat vertigo symptoms, but their effectiveness was not well-researched.
A new analysis found that antihistamines, which are used to treat allergies, were better at treating patients who have acute vertigo, compared to benzodiazepines (or tranquilizers).
The researchers found no studies that suggested benzodiazepines offer any benefits for patients with acute vertigo, according to Benton Hunter, MD, FACEP, lead author of the study and professor of clinical emergency medicine at Indiana University School of Medicine.
Hunter said that providers sometimes prescribe benzodiazepines for vertigo symptoms, but the available evidence suggests that they are ineffective and this class of drugs is highly addictive.
Antihistamines vs. Benzodiazepines
For the analysis, the researchers reviewed data from 17 trials that included 1,586 participants. They found that a single dose of antihistamines resulted in better improvement of vertigo symptoms than a dose of benzodiazepines within two hours.
However, the use of antihistamines did not resolve the symptoms of vertigo entirely after four weeks.
Taking either antihistamines or benzodiazepines daily had no lasting effects on symptom relief either. “It is possible that the body quickly builds tolerance to the vestibular suppressing effect of these medications, or that the medication doesn’t truly have a large beneficial effect,” Hunter said.
The researchers noted that larger randomized trials comparing both antihistamines and benzodiazepines with placebo are needed to better clarify the efficacy of these medications.
Why Might Antihistamines Help Alleviate Vertigo Symptoms?
Antihistamines are thought to suppress the vestibular system, which is a sensory system responsible for providing our brain with information about spatial orientation, motion, and head position.
They work by blocking the signals to the brain that cause vertigo-related symptoms, such as nausea, dizziness, or motion sickness.
Amy Sarow, AuD, a clinical audiologist in Michigan, told Verywell in an email that depending on the cause of vertigo, antihistamines may not always provide relief.
For people who have allergies, the pressure from inflammation in the sinuses can affect the eustachian tube, which can disrupt the inner ear balance system and cause a dizzying sensation.
“If this is the source of the dizziness, antihistamines can help by relieving the inflammation caused by the allergies,” Sarow said. “If the source of the dizziness is not related to allergies, this medication is unlikely to provide benefit.”
What Should You Do If You Have Vertigo?
There are many causes of vertigo and some are treated differently than others, Hunter said. He recommends seeing a healthcare provider to determine the underlying cause and possible treatment options. In most benign cases, medications are not required.
“Our study looked at options for patients with vertigo in general. But, for example, benign positional vertigo is best treated with head exercises and not necessarily antihistamines or any other medications,” Hunter said. “Vertigo can also be a sign of stroke, so I don’t recommend taking any medication without seeing a doctor to determine the cause of vertigo.”
If you need medications to treat your vertigo symptoms, you could discuss with your provider about taking antihistamines.
“Chronic benzodiazepine use is likely a poor option, while antihistamines may be reasonable to try,” Hunter said. “Based on available evidence, benzodiazepines should not be used for vertigo. We did not find any evidence that they are effective at improving symptoms at all.”
