This week we wrap up our short series on Meclizine (with an interruption last week to encourage audiologists to participate in upcoming surveys). I wish I had more information for you, but there just isn’t much out there. That is my concern. I am not “anti-antivert.” I just think it is poorly understood, has not undergone any recent rigorous testing, and is frequently prescribed for symptoms it was never intended to treat. If I woke up spinning and nauseous, I would be looking for some meclizine myself. I have used meclizine in the past to combat seasickness, so I have first-hand knowledge of the drowsiness it causes. I am thankful for the drowsiness as an alternative to seasickness.
I will finish this series with a funny (I think) conversation that took place between me and a patient several years ago. Let’s call him Mr. Snickers.
Mr. Snickers came in telling me that he had recurrent bouts of positional vertigo over the years, but he would take meclizine and the vertigo episodes would go away after several days. I tried to explain to him that this is the typical natural course of Benign Paroxysmal Positional Vertigo, and that he would have improved after several days whether he took the meclizine or not. He was not convinced.
I tried to explain that just because B followed A, that B was not necessarily the result of A (A = meclizine, B = getting better). He was still not convinced. He had made a solid connection in his mind that because he took meclizine and he got better after several days, the meclizine was responsible for his improvement.
I tried one more approach. I said, “It’s not the meclizine that made you better. It’s the time, the several days as you describe. You would have been better just as soon if you had eaten a Snickers bar every morning. They are just as effective at treating BPPV as meclizine, and they are cheaper and taste better”
His response? “I didn’t know that Snickers bars were good for dizziness.”
