Medications
There are several different medications that have dizziness listed as a side effect but some of the more common ones I have observed as a Physical Therapist in practice include cardiovascular medications such as Beta Blockers (Metoprolol), Blood thinners (Eliquis, Coumadin), and muscle relaxers (Baclofen). The reason these medications can cause dizziness is due to the effects they can have on the cardiovascular system. "Beta-blockers, also known as beta-adrenergic blocking agents or beta-adrenoceptor antagonists, are a class of drugs primarily used to manage cardiovascular conditions. They work by blocking the effects of certain hormones, particularly adrenaline (epinephrine), on the beta receptors in the heart and blood vessels. This action results in a decrease in heart rate, blood pressure, and strain on the heart." "Beta Blockers are typically prescribed for controlling hypertension and work to help decrease blood pressure. If blood pressure decreases too much, blood and oxygen does not get to the brain as quickly and can lead to symptoms of dizziness but not typically vertigo. Blood thinners have a similar effect but work differently in regards to their mechanism of action to focus on preventing blood from clotting and are often prescribed following orthopedic surgeries (i.e. joint replacements) to help prevent a DVTs or deep vein thrombosis (a life treatening condition) which can happen due to excessive swelling and edema experienced post-operatively, yet can also yield symptoms of dizziness.
BPPV or Benign Paroxysmal Positional Vertigo
Benign – it is not life-threatening
Paroxysmal – it comes in sudden, brief spells
Positional – it gets triggered by certain head positions or movements
Vertigo – a false sense of movement, often rotational but can be any perceived movement not occurring such as falling, swaying or rocking
"Benign Paroxysmal Positional Vertigo (or BPPV) is the most common cause of vertigo, which is a false sensation of motion, often reported as a spinning sensation. It occurs when calcium carbonate crystals (otoconia) that are normally embedded in gel in the utricle become dislodged and migrate into one or more of the three fluid-filled semicircular canals, where they are not supposed to be. It causes episodes of vertigo, triggered by movement and changes in position. BPPV can be effectively treated with the appropriate mechanical maneuvers performed by a qualified healthcare professional."
I have helped others treat BPPV by something called Canalith Repositioning, which are maneuvers used to help relocate displaced otoconia. One of theses maneuvers is called the Epley Maneuver that you can look into online for more information, but please do not try these without the guidance of a qualified health care professional.
Cervicogenic Dizziness
"The name of this disorder, cervicogenic dizziness, means dizziness produced from the cervical spine or neck region. The neck and cervical spine relay information about the movement and position of the head relative to the body (proprioception). In combination with the vestibular system, this information is used to maintain balance and equilibrium. Neck muscle spasms or fatigue, neck pain, cervical degenerative disease, and neck trauma could alter signals from the neck region and cervical spine, and when it does not match up with the signals from the inner ear (vestibular system) patients may experience vertigo, dizziness, and unsteadiness. Diagnosis requires a combination of patient history, physical testing, laboratory testing, and imaging. Treatment of cervicogenic dizziness is similar to the treatment of neck pain, which may include medications, physical therapy, or surgery." Patients that demonstrate this type of dizzines often have symptoms when they look upwards for a long period of time which can also increase strain on the Vertebral artery (decreasing blood flow to the brain). I have also successfully helped treat many patients with this type of dizziness with targeted stretches and exercises.
These are just a few common causes of dizziness and vertigo that I have commonly treated and worked with, yet there is a much longer extensive list of things that can cause symptoms of dizziness or vertigo. To learn more I encourage you to check out https://vestibular.org. If you are having these symptoms please reach out to me or another qualified health care professional to see how you can treat these symptoms to feel better!
-Dr. Nick Sterling
References:
Causes of dizziness (2024) Vestibular Disorders Association. Available at: https://vestibular.org/article/what-is-vestibular/causes-of-dizziness/ (Accessed: 11 December 2024).
Mentor, P. et al. (2023) Pharmacology of beta-blockers: Pharmacology mentor, Pharmacology Mentor | Expert insights in Pharmacology. Available at: https://pharmacologymentor.com/beta-blockers/ (Accessed: 11 December 2024).
8 muscle relaxer side effects: Drowsiness, dizziness, and more (no date) GoodRx. Available at: https://www.goodrx.com/classes/muscle-relaxants/side-effects (Accessed: 11 December 2024).
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