Use of Vestibular Suppressants in Seniors with Dizziness Triples Fall Risk, Study Finds
USA: A recent study published in the Journal of the American Geriatrics Society has raised concerns over the routine use of vestibular suppressants, such as meclizine and benzodiazepines, among older adults experiencing dizziness. Led by Dr. Schelomo Marmor from the Department of Otolaryngology—Head and Neck Surgery at the University of Minnesota, the research highlights a potential association between the use of these medications and an increased risk of falls in individuals aged 65 and older.
Falls are a major cause of injury, disability, and death among older adults, and the findings from this large-scale study add to growing evidence that certain medications could be contributing to the problem. The study analyzed longitudinal claims data from a national database of U.S. commercial insurance and Medicare beneficiaries, covering the period from January 2006 through December 2015.
The key findings include the following:
- Out of 190,348 individuals aged 65 and older who presented with dizziness, 32% filled a prescription for vestibular suppressants within one month of diagnosis.
- Among those who received these medications, 73% were prescribed anxiolytics, including benzodiazepines, and 27% received antiemetics such as meclizine.
- Women made up 34% of those who were prescribed vestibular suppressants.
- 8% of patients who used vestibular suppressants experienced a fall requiring medical attention within 60 days of filling their prescription.
- After adjusting for demographic and health-related variables, the use of vestibular suppressants was linked to a significantly higher likelihood of falls.
- The adjusted hazard ratio for fall risk among vestibular suppressant users was 3.33, indicating a more than threefold increase compared to non-users.
- Although these medications can offer short-term symptom relief during acute vestibular episodes, their use is not aligned with current clinical guidelines.
- The American Geriatrics Society advises against the routine use of vestibular suppressants in older adults due to their association with increased fall risk and limited long-term benefits.
The study calls for a more cautious approach to treating dizziness in older populations. Researchers advocate for efforts to reevaluate and reduce the unnecessary use of vestibular suppressants through clinician-patient collaboration and guideline-based care. They emphasize the need for shared decision-making, informed by evidence that highlights the potential harms associated with these drugs.
The authors concluded, "By focusing attention on medication-related fall risks, the study aims to support initiatives that prioritize safer and more effective management strategies for dizziness in aging adults. These findings could pave the way for improved care models that minimize harm while addressing the complex needs of this vulnerable population."
Reference:
Marmor, S., Karaca-Mandic, P., & Adams, M. E. (2025). Vestibular Suppressant Utilization and Subsequent Falls Among Patients 65 Years and Older With Dizziness in the United States. Journal of the American Geriatrics Society, 73(5), 1398-1405. https://doi.org/10.1111/jgs.19377
