Medication and dizziness
Medication can cause dizziness or worsen existing dizziness symptoms. This can happen in different ways. Some medicines affect blood pressure, heart rate, alertness, muscle control, balance, sleep, concentration or the nervous system. As a result, someone may feel light-headed, drowsy, unsteady or dizzy.
Sometimes symptoms arise shortly after starting a medicine. Sometimes symptoms arise after increasing or reducing the dose, because of a combination of several medicines, or while tapering or stopping medication.
Medication-related dizziness is more common in older adults and in people who use several medicines at the same time. This is also called polypharmacy.
Important: do not stop prescribed medication on your own. Always discuss dizziness during medication use with your GP, specialist or pharmacist.
Can medication cause dizziness?
Yes, different medicines can cause dizziness, light-headedness, drowsiness or instability as side effects. It is not always vertigo from the balance organ. Medication-related dizziness often feels more like light-headedness, unsteadiness, sleepiness, reduced alertness or the feeling that you might faint.
Medication can, for example, contribute to:
- Lower blood pressure
- A drop in blood pressure when standing up
- A slower or faster heart rate
- Drowsiness or sleepiness
- Reduced alertness
- Reduced coordination
- Muscle weakness
- Blurred vision
- Less stable walking
- A higher risk of falling
Not everyone experiences dizziness from medication. Sensitivity differs from person to person and depends among other things on age, health, dose, kidney function, liver function and combination with other medicines.
When dizziness starts after starting, changing or stopping medication, it is sensible to discuss this with your GP or pharmacist.
Which medicines can cause dizziness?
Different types of medicines can cause or worsen dizziness or instability.
Examples of medicine groups in which dizziness or instability can occur include:
- Blood pressure-lowering medicines
- Diuretics
- Beta blockers
- Medicines for heart rhythm disorders
- Antidepressants
- Sleeping pills
- Sedatives
- Strong painkillers such as opioids
- Some medicines for epilepsy or nerve pain
- Some allergy medicines that cause drowsiness
- Medication that affects the balance system or hearing
This list is not complete. Over-the-counter medicines, alcohol and combinations of medicines can also affect dizziness, drowsiness and balance.
It is not only about one medicine separately. The combination of several medicines can be especially important. When someone uses several medicines that affect blood pressure, alertness, sleep or balance, the risk of dizziness and falls may increase.
Medication groups and symptoms
Why can blood pressure medication make you dizzy?
Blood pressure medication is intended to lower blood pressure or reduce the strain on the heart and blood vessels. This can be medically important. Sometimes, however, blood pressure can become too low or drop too much when standing up.
As a result, temporarily less blood may flow to the brain. This can cause symptoms such as:
- A light-headed feeling
- Blurred vision
- Instability
- Dizziness when standing up
- The feeling that you might faint
These symptoms can fit with orthostatic complaints. In that case, symptoms mainly arise when standing up from a lying or sitting position.
If you become dizzy after starting or adjusting blood pressure medication, discuss this with your GP or pharmacist. Do not adjust medication yourself without consultation.
Can diuretics cause dizziness?
Diuretics are used to help the body pass extra fluid and salt. They can be important, for example, in high blood pressure, heart failure or fluid retention.
In some people, diuretics can contribute to dizziness, especially when there is fluid shortage, low blood pressure or dizziness when standing up.
Symptoms can include:
- A light-headed feeling
- Dizziness when standing up
- Muscle weakness
- Fatigue
- Blurred vision
- The feeling that you might faint
Changes in salts in the blood can sometimes also cause symptoms. This must be assessed by a doctor.
Discuss dizziness during use of diuretics with your GP or pharmacist. Do not stop on your own initiative, because diuretics are often prescribed for a medical reason.
Can beta blockers cause dizziness?
Beta blockers can affect heart rate and blood pressure. In some people this can lead to dizziness, especially when standing up, during exertion or with sudden changes in posture.
Symptoms can include:
- A light-headed feeling
- Fatigue
- Slowness
- Instability
- The feeling that you might faint
Beta blockers are prescribed for various reasons, for example high blood pressure, heart rhythm disorders, heart complaints, migraine or other conditions. That is why it is important not to stop this medication yourself.
Discuss dizziness during use of beta blockers with your GP, specialist or pharmacist.
Can antidepressants cause dizziness?
Some antidepressants can cause dizziness, drowsiness, light-headedness or instability. This can occur especially in the first period after starting, when the dose is increased or reduced, or when tapering or stopping.
The symptoms can take different forms. Some people experience a light-headed feeling, sleepiness or unsteadiness. Others describe a strange, floating or unstable feeling.
Antidepressants can also affect sleep, alertness, blood pressure or balance. As a result, the risk of dizziness or falling can increase, especially in older adults or when combined with other medicines.
If you become dizzy after starting or adjusting antidepressants, discuss this with the prescribing doctor or pharmacist. Do not stop abruptly without medical consultation.
Can you become dizzy when you stop antidepressants?
Yes, temporary symptoms can occur when tapering or stopping antidepressants. These are sometimes called withdrawal symptoms or tapering symptoms.
Possible symptoms are:
- Dizziness
- A light or floating feeling
- Nausea
- Restlessness
- Sleep problems
- Headache
- Sensitivity to movement
- A strange electric sensation in the head or body
These symptoms mainly arise when medication is tapered too quickly or stopped abruptly. Not everyone experiences them.
If you experience dizziness while tapering antidepressants, discuss this with the prescribing doctor or pharmacist. Sometimes a slower tapering schedule is needed.
Can sleeping pills cause dizziness?
Yes, sleeping pills can cause drowsiness, sleepiness, reduced coordination and instability. As a result, someone may feel dizzy or walk less steadily.
Especially in older adults, sleeping pills can increase the risk of falls. Drowsiness may also still be present the next morning, which can make walking, climbing stairs, cycling or driving less safe.
Symptoms can include:
- Dizziness
- Sleepiness
- Unsteady walking
- Reduced concentration
- Slower reactions
- Muscle weakness
- A higher risk of falling
Use sleeping pills only as prescribed. Discuss persistent dizziness, drowsiness or instability with your GP or pharmacist.
Can sedatives cause dizziness?
Sedatives can affect the nervous system. They can reduce tension, but can also cause drowsiness, reduced alertness, muscle weakness and instability.
Some people notice that they walk less steadily, react more slowly or become dizzy more easily. This can occur especially at higher doses, in combination with other substances or when used by older adults.
Sedatives can also increase the risk of falls. This is especially true when they are combined with sleeping pills, alcohol or other medicines that cause drowsiness.
Always discuss dizziness or instability during use of sedatives with your GP or pharmacist.
Can strong painkillers cause dizziness?
Strong painkillers, such as opioids, can cause dizziness, drowsiness, nausea and instability. They can also reduce reaction speed.
This can occur especially at the start of treatment, after increasing the dose, or when these medicines are combined with sleeping pills, sedatives or alcohol.
Symptoms can include:
- Drowsiness
- Dizziness
- Nausea
- Unsteady walking
- Reduced concentration
- A higher risk of falling
Use strong painkillers only as prescribed. Discuss dizziness or drowsiness with the prescribing doctor or pharmacist.
Can medicines for epilepsy or nerve pain cause dizziness?
Some medicines for epilepsy or nerve pain can cause dizziness, sleepiness, blurred vision or coordination problems. These medicines act on the nervous system and can therefore affect balance and alertness.
The symptoms can occur especially when starting, increasing the dose or combining them with other medicines that cause drowsiness.
Discuss dizziness, unsteadiness or blurred vision during use of these medicines with your GP, specialist or pharmacist.
Can antibiotics cause dizziness?
In some people, dizziness or a light-headed feeling can occur during a course of antibiotics. This can be caused by the medicine itself, but also by the infection, fever, reduced appetite, dehydration or general weakness.
Not every course of antibiotics causes dizziness, and in most people there is no lasting effect on the balance system.
With certain medicines, an effect on hearing or balance can play a role. This is not the same for all antibiotics. If new hearing loss, tinnitus, severe vertigo or clear balance problems occur during or after medication, it is important to contact the doctor or pharmacist.
Do not stop antibiotics without consultation, because the infection may then be treated insufficiently.
Can medicines for dizziness themselves cause side effects?
Sometimes a doctor temporarily prescribes medication for dizziness, nausea or motion sickness. Some of these medicines can cause drowsiness, sleepiness, dry mouth, blurred vision or reduced alertness.
In acute nausea or severe vertigo, temporary medication can sometimes be useful. Long-term use is not always desirable, however, because drowsiness and reduced alertness can affect daily functioning.
In some forms of vestibular rehabilitation, it is also important that the balance system actively learns to recover. Therefore always discuss long-term use of medicines for dizziness with the doctor or pharmacist.
Why is medication-related dizziness more common in older adults?
Medication-related dizziness is more common in older adults. There are several reasons for this.
The body sometimes processes medicines differently at an older age. The kidneys and liver may also work more slowly, causing some medicines to work longer or more strongly. In addition, older adults more often use several medicines at the same time.
Other factors also often play a role in older adults, such as:
- Blood pressure changes
- Reduced muscle strength
- Reduced vision
- Balance problems
- Neurological conditions
- Greater sensitivity to drowsiness
- Higher risk of falling
When an older patient becomes dizzy, it is important to include medication use in the assessment. A medication check or medication review by the GP and pharmacist can be useful.
Dizziness caused by a combination of medicines
Sometimes dizziness is not caused by one medicine, but by the combination of several medicines. This occurs especially when several medicines affect blood pressure, heart rate, alertness, sleep, muscle control or balance.
Examples include combinations of blood pressure medication, diuretics, sleeping pills, sedatives, antidepressants, strong painkillers or other medicines that cause drowsiness.
The symptoms can develop gradually. As a result, the connection with medication is not always immediately clear.
In long-lasting or unexplained dizziness, it is sensible to bring an up-to-date medication overview to the assessment. Assessment by a GP or pharmacist may also be needed.
What can the pharmacist do for dizziness?
The pharmacist can help assess whether medication may play a role in dizziness, drowsiness or instability. The pharmacist can look at the dose, combinations of medicines, side effects, interactions and the moment when symptoms started.
The pharmacist can also help with an up-to-date medication overview. This can be useful when visiting a GP, specialist or physiotherapist.
In older adults who use several medicines long-term, a medication review by the GP and pharmacist can sometimes be useful. This looks at whether all medicines are still necessary and appropriate, and whether side effects or combinations may be causing problems.
What can Duizeligheid.nl do for possible medication-related dizziness?
Duizeligheid.nl does not adjust medication and does not give medication advice in the way a GP, specialist or pharmacist does.
We do include medication use in the analysis of dizziness symptoms. During the assessment, we look at the symptom pattern and at factors that may cause or worsen the dizziness.
When the symptom pattern points to a possible relationship with medication, we advise discussing this with the GP or pharmacist.
When, in addition to medication, there are also balance complaints, instability, motion sensitivity or residual symptoms after a vestibular condition, physiotherapy assessment and treatment can sometimes be useful.
The treatment then focuses not on the medication itself, but on balance, stability, confidence in movement and recovery of the balance system.
When should you contact a doctor?
Contact your GP, specialist or pharmacist when dizziness starts after starting, stopping or adjusting medication.
Contact a doctor or out-of-hours GP service immediately in case of:
- Fainting
- Chest pain
- Severe shortness of breath
- New neurological symptoms
- Double vision
- Speech problems
- Loss of strength
- Sudden hearing loss
- Severe drowsiness or confusion
- Acute severe dizziness with inability to stand or walk
- Dizziness after a fall or blow to the head
Do not stop prescribed medication on your own initiative. Always consult the prescribing doctor, GP or pharmacist first.