So I was having a weird reaction to my sleeping pill Zopiclone. As in, when I took it, it dampened the vertigo.
And this seemed weird. But when you look it up this is what you will find: “Chemically, zopiclone is a cyclopyrrolone.3 It is a type A γ-aminobutyric acid (GABA) receptor agonist and therefore enhances GABA-related neuronal inhibition. Benzodiazepines also bind to and affect the function of GABA receptors.” Zopiclone
So in a sense, it was helping suppress the vertigo as well. And that made me look at things like Valium and Ativan which are frequently recommended in a vestibular migraine group I am in.
Benzodiazepine for vertigo treatment
So benzodiazepines apparently suppress vestibular functions. They are often used in the ER for vertigo, but they can be also used for chronic problems in small doses. “Benzodiazepines are GABA modulators, acting centrally to suppress vestibular responses. They increase the affinity of chloride channel opening (Soto et al, 2013). There are differential effects across benzodiazepines on Gaba-A receptor subtypes. In small doses, these drugs are extremely useful.” Dizziness and benzodiazepines
benzodiazepines medication treatment for chronic dizziness:
- diazepam (Valium) Dosage 2mg twice a day
- lorazepam (Ativan) Dosage .5 twice a day
- Clonazepam Dosage .5 twice a day
- alprazolam (Xanax) .25 for treatment in ER, not recommended for chronic conditions.
Benzodiazepines are commonly used in emergency departments and medical offices to treat vertigo. We think this is reasonable, albeit in small doses. By small, we mean 5mg of diazepam (or less), or 1 mg of lorazepam (or less). We do not think that this amount of diazepam or lorazepam should be continued for long periods of time, for acute vertigo. However, if all else fails and given objective evidence for vertigo (e.g. nystagmus), we do think that chronic use is justifiable, based on a “less harm” reasoning. Dizziness and benzodiazepines
I went to my doctor with my new found information and experience with my sleeping pill. My doctor said she wouldn’t usually prescribe them but in my case, my vertigo is enduring and severe. And she said at a certain point we have to look at quality of life.
So she prescribed .5 mgs of Ativan for me to try twice a day. And maximum 1 mg when the one pill didn’t work. .5 works on a good day in the morning and afternoon. I haven’t tried it yet during a bad day. But when the vertigo gets severe as the day goes on 1mg worked a lot better.
It is suppressing the vestibular symptoms but not eliminating them. And it doesn’t seem to help much with the disequilibrium symptoms. That seems to remain to an extent. I’ll have to see if it helps with the severe disequilibrium which can cause drop attacks. Just the insane dizziness, vertigo sensations, and the intense brain fog associated with that. Also, I found abrupt head movements still cause discomfort… just not the whole world whirling away from me. So head movement is still really uncomfortable. Just not as severe. I will have to see how it helps with functionality the more I take it to reduce symptoms. I have tried it just the one day so far.
It should be noted that vestibular migraine is usually treated with certain preventatives. Ones I never responded to. It also should be noted vestibular migraine is a migraine and as such the symptoms do not typically last more than 72 hours. In my case, it has been constant since last November.
But I now wonder can I go outside and socialize without things getting progressively worse? Can I go longer distances from the house without the driving making it worse and then the symptom severity making me functionally useless? Can I get some things done around the house without needing an extensive nap afterwards? Can I take walks and exercise again? I don’t know yet. But I will find out what I can and cannot do. I think driving is still out of the question though.