Dizziness is a non-specific term used to express a variety of sensations like lightheadedness, imbalance, or like the room is spinning.
Its causes range from standing up too quickly to more serious conditions—like vertigo—that merit medical treatment. Most of the time, dizziness is an acute symptom that resolves quickly and on its own, but sometimes it may signal a more serious problem.
This article discusses the symptoms and potential causes of dizziness and covers the risk factors and when to seek tests or treatment for your symptoms.
Symptoms of Dizziness
Dizzy is a subjective feeling that differs from person to person. Dizziness is most commonly described as one of the following sensations:1
- Feeling like your spinning or disoriented
- Unsteady (like you are going to lose your balance)
- A swimming feeling like you need to hold onto something or concentrate while walking
Sometimes dizziness is also accompanied by:
- Loss of consciousness
Types of Dizziness
The various types of dizziness are outlined below.
Vertigo is a subtype of dizziness characterized by a sensation of motion either of the body or the surrounding environment due to dysfunction of the vestibular system, which helps maintain balance.
Vertigo is most commonly described as the feeling of the room spinning while you’re still. There are many different subtypes of vertigo, such as:
- Vestibular neuritis
- Benign paroxysmal positional vertigo (BPPV)
- Vestibular migraine (the most common type)
The cause of your dizziness may differ depending on the subtype, but they all show some level of discord in how the brain interprets visual information about one’s position in space.2
Of note, vertigo can be a medical condition in and of itself—oftentimes of unknown origin—or a symptom of an underlying medical condition such as a metabolic disorder like kidney failure, multiple sclerosis, or stroke.
Presyncope is that faint feeling you feel when you get up too quickly. More commonly known as lightheadedness, presyncope occurs when blood is restricted to the brain.3
Disequilibrium is the feeling of unsteadiness or imbalance often associated with inner ear dysfunction, ear infections, and neuro-degenerative conditions, such as Parkinson’s disease.4
Causes of Dizziness
The foremost common causes of dizziness are:
- Ear infections
- Inner ear disorders (such as benign paroxysmal positional vertigo [BPPV] and Meniere’s syndrome)
- Motion sickness
- Side effects from medication
It’s also important to note that sometimes the cause of your dizziness simply cannot be explained.
What Medications Can Cause Dizziness
Any medication that is toxic to the inner ear (ototoxic) or can precipitate an electrolyte imbalance in the body has the potential to cause dizziness.
The following medications (and their drug classes) most commonly trigger medication-induced vertigo-like symptoms:5
- Analgesics (codeine)
- Antibiotics (aminoglycosides, macrolides, minocycline, nitrofurantoin, sulfamethoxazole)
- Anticonvulsants (levetiracetam, phenytoin, pregabalin)
- Anti-inflammatories (celecoxib, parecoxib, naproxen, prednisone)
- Antimalarials (mefloquine, quinine, hydroxychloroquine)
- Antivirals (oseltamivir, raltegravir)
- Anti-Parkinson’s drugs (lisuride)
- Cardiovascular drugs (nifedipine, furosemide, indapamide, prazosin, terazosin, glyceryl trinitrate, isosorbide mononitrate, sotalol, timolol)
- Gastroenterology drugs (omeprazole, lansoprazole, sucralfate)
- Rheumatology drugs (zolendronic acid, alendronate)
- Phosphodiesterase type-5 inhibitors (sildenafil, vardenafil)
- Other medicines (lithium, haloperidol, benzodiazepines, desmopressin, melatonin)
How to Treat Dizziness
Finding the root cause of your dizziness will determine the best course of action for you.
- Inner-ear issues: If the cause of your dizziness is due to inner-ear issues, it can usually be well managed with medications, at-home positional exercises, or canalith positioning procedures—a special set of exercises performed by your physical therapist designed to remove inner ear crystals.
- BPPV: This can be resolved with canalith positioning procedures, a special set of exercises performed by your physical therapist designed to remove inner ear crystals. Surgery is not usually indicated.6
- Migraines: These can be treated with triptan medication, an anti-inflammatory diet, avoiding common migraine triggers, and anti-nausea medication such as Zofran ODT (ondansetron).
- Meniere’s disease: This is an inner ear disorder characterized by severe dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or congestion in the ear. The exact cause of Meniere’s is a mystery, and there is no cure, but your symptoms may be mitigated with a low-salt diet and balancing exercises to ‘retrain’ the nervous system. Prescription drugs such as meclizine, diazepam, glycopyrrolate, and lorazepam can also help relieve dizziness and shorten the duration of your dizzy spells. In more severe cases, injections with the antibiotic gentamicin or ear surgery may be indicated.7
- Panic disorder: If this is the cause of your dizziness, cognitive behavioral therapy may be helpful. Taking anti-anxiolytics and using breathing exercises may also provide added benefits if anxiety is at the root of your dizziness.
- Electrolyte or hormonal imbalance: To help this, drinking an energy drink such as zero-sugar Gatorade or Powerade, as well as plenty of water, can reverse your chemical imbalance and dehydration, resolving your dizziness along the way. Be sure to avoid strenuous exercise and excessively hot places for additional relief.