"Understanding Dizziness as a Side Effect of Medications"

https://www.verywellhealth.com/is-my-dizziness-a-side-effect-2488844

 

Understanding Dizziness as a Side Effect of Medications

By Peter Pressman, MD | Medically reviewed by a board-certified physician | Updated May 07, 2019

 

 

Dizziness is one of the most common side effects associated with medications. This is partially due to the complexity of the vestibular system (your "dizzy" system) and the ease with which something can go wrong. Another factor is the sheer number of things that people mean when they say they are dizzy, as the term "dizziness" can stem from a variety of unique causes.

 

When Dizzy Means Lightheadedness

 

To be lightheaded means the kind of dizziness people feel when they stand up too quickly and feel they may pass out (this is called pre-syncope). This sensation comes from the brain temporarily not getting enough oxygen, which is delivered through blood flow.

 

To get the blood up to the brain, a certain degree of pressure is required to overcome the pull of gravity. Without that pressure, blood falls away from the brain, and lightheadedness or even fainting can result.

 

Of course, if your blood pressure is too high, it increases your risk for all kinds of diseases such as stroke or heart disease. For this reason, doctors prescribe many different types of medications to treat high blood pressure (hypertension). These antihypertensive medications work in a variety of different ways. For instance, some make you urinate so that there is less fluid in the body to keep the pressure up (diuretics) and some dilate artery walls to give the blood more room (vasodilators).

 

Some people have blood pressure that varies more than others throughout the day. So if doctors see such a person when his blood pressure is high, they may prescribe a blood pressure medication. When the blood pressure naturally lowers, it will fall even further, and perhaps not be enough to get blood to the brain, resulting in lightheadedness. This is why doctors will often ask patients to record their blood pressures at home, multiple times a day for a few days, before prescribing a blood pressure medication.

 

Other medications that can cause this kind of lightheadedness include tricyclic antidepressants and some medications for Parkinson's disease.

 

When Dizzy Means Disequilibrium

 

Some people say they are dizzy when they mean that they are clumsy. Sometimes this clumsiness can make it difficult to even walk correctly. Medications like some antiepileptics can affect the workings of the cerebellum—the part of the brain that is responsible for coordinating our movements. Other potential culprits include benzodiazepines or lithium. Lithium, in particular, has what is known as a narrow therapeutic window, meaning that there is just a small difference between a dose that doesn't actually treat someone's problem and a dose that causes new side effects. For this reason, people on lithium should have a blood level tested frequently to ensure that the blood concentration of the medication is within a safe limit.

 

When Dizzy Means Vertigo

 

Vertigo is a false sense of movement, like most of us have had after stepping off a merry-go-round or dizzying amusement park ride. Vertigo can either result from a problem with our inner ear, the nerve between the inner ear and the brainstem, or the brain itself. Medications like antihistamines, benzodiazepines, or anticholinergics can suppress the vestibular system and may do so in a way that causes dizziness or imbalance. The antibiotics known as aminoglycosides, such as gentamicin or tobramycin, can have a toxic effect on the inner ear, leading to permanent vertigo. Other drugs that can be toxic to the vestibular system include quinine, certain chemotherapies, salicylates like aspirin, and loop diuretics like furosemide.

 

When Dizzy Means Other Sensations

 

The term dizziness can be so vague that people will use it to signify almost any symptom, including tingling, weakness, confusion, and more. For this reason, it's difficult to list all the different drugs that could cause all of these symptoms. It's worth mentioning though that low blood sugar can cause these dizzy-related symptoms. So medications that lower blood glucose levels, like some diabetes medications, should also be considered among potential culprits when someone has dizziness.

 

Bottom Line

 

When considering whether dizziness is due to a medication, consider whether the problem began soon after a new drug was prescribed or the dose of a drug was increased. Sometimes, though, a drug takes time to damage the vestibular system, as is the case for aminoglycosides—so it may be a while before the symptom of dizziness is experienced.

 

In addition, dizziness that always follows the taking of a medication is certainly suspicious, but constant dizziness may also be caused by drugs. For example, if the concentration of a drug in the blood remains fairly constant between doses, there may not be much fluctuation in side effects.

 

In general, it's best to be mindful of the potential side effects of medications and to discuss the proper management of those drugs with your health care provider.

Thank you for this, Lapis!!!

 

I'm finding that I now have orthostatic hypotension. When I stand up, I feel very dizzy, my eyesight gets fuzzy, and sometimes I have to lie down. This began to happen after my bladder cancer surgery. I've discussed it with the doctor. She thinks it has something to do with excessive thirst and the fact that I am now on Lasix, 1/2 of a 20-mg. pill. But after the surgery and all the drugs plus a chemo wash, I think my body had too much to process. My left leg and ankle were very swollen and painful. I'm having a blood test this week and will find out my sodium level. Diuretics of course make one thirsty, and they throw the electrolytes off. Unfortunately, my kidneys aren't doing well, and diuretics can affect them, too. I know for a fact that bp pills cause excessive thirst because they seem to suck up any available water I have.

 

It can be very difficult to navigate walking anywhere, but I have to do it. I have no car and no one living with me. It causes me to think so highly of people who are feebly walking along, doing their grocery shopping.

 

I've been dizzy ever since tolerance, so I know it has to do with the benzo symptoms along with the bp drugs I take. I have no choice but to taper very slowly off of them, and I'm finding that the lower I go, the better my bp is - which seems paradoxical, but not when one considers that trying to "fix" a bp problem has caused doctors to over-prescribe. Each pill carries its own interactions, which can cause havoc to a sensitive body (I only weighed 113 in the doctor's office with clothes and shoes on, and I'm 5'5"). More pills IS NOT the answer, and the body does a delicate dance, which is upset by drugs and can cause terrible dizziness.

Hey Terry,

I know you've been struggling for a long time with all these medication side effects, and I keep hoping that things settle down for you. Maybe soon? Fingers crossed!

 

I'm still dealing with intense disequilibrium -- different than what you have -- but it's also disabling. It's as if I'm on a boat all the time, and sometimes, the waters are really rough. Mine is caused by the benzos and SSRIs. I don't doubt that genetics and hormonal changes are playing their part as well. It's been a nightmare, really. 

Yes, you have it right, Lapis - nightmare to the max. I say that so many times to myself. Wish we didn't have to go through this and wonder when it will all be over. It's lasted far too long...