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Drug-induced dizziness
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Drug-induced dizziness

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Contributors: Sigriet Ferrer MLIS, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Drug-induced dizziness is a common adverse drug effect. The patient may experience any of 4 basic sensations (subtypes): vertigo (a spinning sensation or false sense of motion), disequilibrium (feeling wobbly or off-balance), presyncope (a feeling of impending loss of consciousness, which may lead to true syncope), or lightheadedness (feeling of disconnect with environment). These symptoms can be indistinct and occur together. Any of these may be accompanied by other symptoms, including nausea or mental fogginess.

While many drugs may be implicated in causing dizziness (see Drug Reaction Data below), the following are the most frequent culprits:
  • Aminoglycoside antibiotics (gentamicin, streptomycin) and other ototoxic drugs (eg, cisplatin) may induce vertigo or disequilibrium.
  • Antihypertensive and diuretic drugs may cause lightheadedness and presyncope by mechanism of inducing postural hypotension and reduced cerebral blood flow.
  • Anticonvulsant drugs (carbamazepine, phenytoin, primidone) and alcohol may cause acute (reversible) disequilibrium or chronic (irreversible) disequilibrium, resulting from cerebellar dysfunction.
  • Sedating drugs (barbiturates, benzodiazepines, and tricyclic antidepressants) can cause a nonspecific dizziness that is possibly related to central nervous system depression.
  • Several drugs can produce a distinctive drug-intoxication syndrome, presenting with disorientation, memory and cognitive impairments, gaze-evoked nystagmus, and gait disturbances. This is especially important to distinguish from drug-induced dizziness as it can be confused with more serious conditions.
  • Alcohol may cause central nervous system (CNS) depression and cerebellar toxicity, which may result in dizziness from ingestion.

Codes

ICD10CM:
R42 – Dizziness and giddiness
T50.905A – Adverse effect of unspecified drugs, medicaments and biological substances, initial encounter

SNOMEDCT:
473188002 – Dizziness due to drug

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 08/10/2018
Last Updated: 09/06/2018
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Drug-induced dizziness
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Drug-induced dizziness : Dizziness
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