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The Dizziness Group: For those who are floating, boating, falling or flying


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It is going to take me considerably longer to taper than what I originally took it for which is one of the things that astounds me the most. I don’t know why I was prescribed 4mg of a benzo as a first choice of treatment for anxiety, considering I had never taken meds for this prior. It’s sad but I try not to dwell on it and focus on my progress instead. I’m now at 1.5mg which is more than half way there and that makes me happy. But definitely more cautious now that I know I’m prone to dizziness with it!
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Yes, just take the time you need to safely taper, HealthFighter. I don't think there's an advantage to rushing off the medication, even though I'm sure you want to be done with the whole thing. It's about allowing your brain to adjust to the decreases in the daily dose, and the timetable for that is obviously not set in stone. Everyone is different.

 

Congratulations on getting past that halfway mark! I wish you all the best with the taper.  :thumbsup:

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Hi Dizzy Buddies,

I just came across a study on PubMed that might be of interest to people around here. It's about vertigo in older adults, which is, unfortunately, fairly common. One thing that's mentioned in the abstract is the use of medication and the possibility that it interferes with the brain's attempts to normalize when there's been an issue with balance. I'll highlight the line in the abstract in that best expresses that point.

 

Benzodiazepines are known as "vestibular suppressants" in the medical literature, and they are often prescribed for short periods of time when someone has a bout of vertigo. However, they can interfere with vestibular compensation if taken too long, and, obviously, worsen the problem.

 

Here are the "Key Points" taken from the full study, followed by the abstract and a link to the full study, if you want to read more:

 

Key Points:

 

Vertigo and dizziness frequently affect the adult population and greatly contribute to fall-associated trauma, especially in older patients; the three classes of otological, central, and functional dizziness may be distinguished.

 

Older patients are subjected to multiple comorbidities and various pharmacological therapies, which in turn could cause dizziness.

 

The use of vestibular suppressants for the management of vertigo should be limited only to the acute phase of the disease, and such drugs must be used with caution in the older population because of their side effects and potential interactions with other pharmacological treatments.

 

In older patients, physical activity and vestibular rehabilitation exercises are recommended for more rapid and complete vestibular compensation; repositioning maneuvers are highly indicated and effective in the older population with benign paroxysmal positional vertigo.

 

 

"Current Insights into Treating Vertigo in Older Adults"

 

Augusto Pietro Casani  1 , Mauro Gufoni  2 , Silvia Capobianco  2

 

Affiliations

 

    1

    Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT Section, Pisa University Hospital, Via Paradisa, 2, 56126, Pisa, Italy. augusto.casani@unipi.it.

    2

    Department of Surgical Pathology, Medical, Molecular and Critical Area, ENT Section, Pisa University Hospital, Via Paradisa, 2, 56126, Pisa, Italy.

 

    PMID: 34159566 PMCID: PMC8342368 DOI: 10.1007/s40266-021-00877-z

 

Abstract

 

The number of older people has been increasing over recent decades in Western populations. Dizziness, imbalance, and vertigo constitute some of the most common complaints in older patients, and risk of falling is the most frequent and worrying consequence. It has been reported that 15-20% of the adult population experiences these debilitating symptoms. Among the diseases that may be associated with vertigo, the three classes of otological, central, and functional (psychological) dizziness may be distinguished. Overall, vestibular disorders account for 48% of vertiginous complaints in the older population. The main focus of this article is to review the forms of pharmacotherapy for vertigo, especially with regard to older patients, who may be treated simultaneously with other drugs for different comorbidities. Interactions with other drugs should be considered in the choice of a particular course of treatment. Moreover, overuse of pharmacotherapy for the management of vertigo in the elderly may prevent the development of the central compensatory mechanism that sustains both static and dynamic imbalance after a vertiginous crisis. In the majority of patients, vestibular and physical rehabilitation are strongly advised and rarely contraindicated.

 

Full Study:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342368/ 

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Thank you Lapis. That's an interesting study and makes perfect sense to me.  I'm 3 months off meds and am still having a couple of days a week with vertigo and balance issues.  My brain is working hard to adjust but not there yet.

 

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Yes, for sure, Helen, it can take some time. It seems to be really variable, and I'm sure genetics can play a role, among other things (dose and type of medication, how long you were on it, etc.). I hope it won't take too long for your brain to get there.  :)
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Thank you, Lapis! You've been off the meds since 2014? How is your balance now?  Sorry if you have answered this a million times. I can scroll back if you don't want to go into it again.

 

 

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Has anyone had a return, or increase, or a new onset of vestibular or vertigo symptoms with any of the Covid vaccines?

 

Or with Covid itself?

 

Miss Fortitude

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Yup, I do…

 

I always get so anxious when it hits, deathly afraid of passing out, not sure why. But it comes on so strong, and if I’m in public, I try to find something to sit on, just because it feels like I’m going to faint… I never have though, so I try to think about that.

 

Try not to think that u will faint and distract yourself so it goes away.

 

Karla

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Yup, I do…

 

I always get so anxious when it hits, deathly afraid of passing out, not sure why. But it comes on so strong, and if I’m in public, I try to find something to sit on, just because it feels like I’m going to faint… I never have though, so I try to think about that.

 

Try not to think that u will faint and distract yourself so it goes away.

 

Karla

 

Thanks for the reply Karla! 

 

It’s the same for me.  I get the head pressure and the lightheadedness. Fearful that I may pass out, but like you, I never have and I try to use that as a tool when it hits. 

 

I have it moderately 24/7 but it’s the acute episodes that scare my like something else is dreadfully wrong. It seems to get worse when I exert myself or bend over, then the heart stuff starts. UGH!

 

I hope we all get some relief soon!

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Oh boy. This is so not fun. I've been basically immobile with these type symptoms for several days now. It's freaky and awful.  Do you all get tight in the chest while it is happening? Heart palpitations with it?
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Hi Helen, Yes, heart palps also.  I captured them with the ECG on my Apple Watch.  My doctor says they are PAC’s. Informed me that they are not life threatening, just annoying. Easy for her to say! 🤷🏻‍♂️

 

Hope you get some relief soon !!

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Hopper14,

 

Yes! Haha. Easy for her to say. Sometimes those palps feel like a heart attack must surely be imminent.  Thanks for responding. It's such a bizarre cluster of symptoms that happen all at once and very disorienting. 

 

Thanks for the good wishes. Same to you and stay safe tottering around!

 

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  • 2 weeks later...
I have been tapering off of that rat poison clonazepam for a year now, after using it for three months. I have just about every symptom listed, but last week I got vertigo for the first time. I am down to 0.008 mg/day and am in hell. Every 1 ug cut causes my symptoms to worsen, and new ones appear. I don’t think I will survive the cut to zero. My question to all of you is has anyone recovered from benzo-induced vertigo? If so, how long did it take? I have no quality of life anymore and will probably soon lose my job. Please help! Is there any hope?
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I have been tapering off of that rat poison clonazepam for a year now, after using it for three months. I have just about every symptom listed, but last week I got vertigo for the first time. I am down to 0.008 mg/day and am in hell. Every 1 ug cut causes my symptoms to worsen, and new ones appear. I don’t think I will survive the cut to zero. My question to all of you is has anyone recovered from benzo-induced vertigo? If so, how long did it take? I have no quality of life anymore and will probably soon lose my job. Please help! Is there any hope?

 

Hi Skyglider,

The thing about benzos and Z-drugs is that they can affect the vestibular system (balance) while you're taking them, during withdrawal and in the post-withdrawal period, so it's pretty unpredictable. Lots of people have this symptom and then, like the other symptoms, it can pass. There's no clear time frame, though, so it would be impossible to give you a prediction or even an average time regarding how long it might take for your dizziness to settle down. It's such an individual thing. Genetics can play a role, as can the type of medication, dose, how long you took it, etc.

 

 

 

 

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Hi Lapis2,

 

Yes, I know it is unpredictable. However, I don’t see any real success stories and that frightens me to death. I have so many symptoms like POTS, full body numbness, constant dizziness for over a year, burning skin, constant headaches/migraines. Constant anxiety. Looping thoughts. Severe insomnia. The list goes on and on. Now vertigo. I can’t take it anymore. I want to know people really can heal.

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Hi Skyglider,

The thing is.....there are so many success stories. Pages and pages and pages. People don't necessarily come back here and tell us they're better, so we just don't have solid data on it. That's the nature of BB. It's all over the place. It's a place for support, but it can't provide data. It's not set up that way.

 

We all want that kind of info, believe me. All I can suggest is to read the success stories. Those are real people who went through it and came out the other end. That's why the stories are there...to provide hope and inspiration.

 

 

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Thanks for the reply, I was aware of the vestibular issues due to withdrawals from your previous posts. I started a supplement called L-Lysine few days ago and for the first 2-3 days I felt most of my dizziness was going away which made me jump from happiness. Then gradually it stopped working. I know Lysine is a antiviral supplement so I wanted to give it a try. Im still taking it and hope I am not making my vestibular system go lazy and thus slow down healing. Any inputs.
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Hopefully, L-Lysine will continue working. Please keep me updated on your progress. I am really in a bad way, and have been for a very long time. I feel like I am losing my mind at this point. I don’t know what to do or try, and often feel there is no point continuing anymore. I am so depressed.
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Hi Everyone,

I just wanted to share these abstracts from a recent otolaryngology review. The first one is called "Acute Vestibular Syndrome and ER Presentations of Dizziness", and in listing the various possible causes of dizziness people experience, "medication effects" are included...thankfully. It also states, though, that it can be difficult to figure out what's causing someone to feel dizzy -- a fact that comes up very often in abstracts and studies on this topic. Dizziness is such a common symptom, and it can have so many different causes -- some more serious than others.

 

Here's the abstract:

 

https://pubmed.ncbi.nlm.nih.gov/34294435/ 

 

Abstract

 

Acute vestibular syndrome (AVS) describes sudden onset, severe, continuous dizziness that persists for more than 24 hours. Its wide differential presents a diagnostic challenge. Vestibular neuritis is the most common cause, but stroke, trauma, medication effects, infectious, and inflammatory causes all present similarly. The TiTrATE model (Timing, Triggers, And Targeted Exam) is systematic way to evaluate these patients, and the HINTS Plus exam (Head Impulse, Nystagmus, Test of Skew, plus hearing loss) is critical in differentiating central and peripheral causes. The importance of recognizing risk factors for stroke and the role of imaging is also discussed.

 

And here's a related abstract from the same journal. It looks at the different kinds of testing that are used to determine the cause of dizziness.

 

"Efficient Use of Vestibular Testing"

 

https://pubmed.ncbi.nlm.nih.gov/34294436/

 

Abstract

 

While the majority of vestibular disorders may be diagnosed solely on clinical grounds, a variety of clinical scenarios exist in which objective functional assessment of the vestibular system provides data that facilitate diagnosis and treatment decisions. There exists a veritable armamentarium of sophisticated vestibular test modalities, including videonystagmography, rotary chair testing, video head impulse testing, and vestibular-evoked myogenic potentials. This article aims to help clinicians apply an accessible decision-making rubric to identify the clinical scenarios that may and may not benefit from data derived from specific vestibular function tests.

 

 

And this one -- part of the same series of reviews in an otolaryngology journal -- says something that I've come to know very well while going through all of this and doing so much reading on it. The first line of the abstract is the key line: "Despite progress in vestibular research in the last 20 years, much remains poorly understood about vestibular pathophysiology and its management." Yup, thanks.

 

"New Frontiers in Managing the Dizzy Patient"

 

https://pubmed.ncbi.nlm.nih.gov/34294438/

 

Abstract

 

Despite progress in vestibular research in the last 20 years, much remains poorly understood about vestibular pathophysiology and its management. A shared language is a critical first step in understanding vestibular disorders and is under development. Telehealth will continue for patients with dizziness, and ambulatory monitoring of nystagmus will become a diagnostic tool. In the next 2 decades, it is anticipated that vestibular perceptual threshold testing will become common in tertiary centers, imaging with improved spatial resolution will yield better understanding of vestibular pathophysiology, and that vestibular implants will become a part of clinical practice.

 

 

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