Drugs and Vertigo

The list of drugs which may have adverse effects on hearing or balance is impressive. It includes anaesthetic agents, anticonvulsants, antidepressants, analgesics, antidiabetic agents, antihypertensive agents, anti-inflammatory drugs, contraceptives, cytotoxic agents, cardiovascular drugs, sedatives, and tranquilhsers (Table 21.1; Ballantyne and Ajodhia 1984). There is no common syndrome or mechanism of drug vertigo. The spectrum covers all kinds of side effects. Beta-blockers may induce bradycardia with unspecific drowsiness or dizziness (Cruickshank 1981). More severe side effects include hypoglycaemia (Harrill 1951; Currier 1970), positional alcohol nystagmus/vertigo (p. 154), cerebellar ataxia and oculomotor dysfunction in acute diphenylhydantoine intoxication (Nozue et al. 1973), and bilateral vestibular loss with oscillopsia and unsteadiness of gait due to gentamicin toxicity (Ramsden and Ackrill 1982). Drug induced patterns of pathological eye movements include positional, downbeat, and gaze-evoked nystagmus and preferably reflect transient flocculus dysfunction (Esser and Brandt 1983).