Which statements describe common acute pharmacologic management of vertigo and its limitations?

• A. Vestibular suppressants cure the underlying vestibular disorder.
• B. They have no sedative effects.
• C. Vestibular suppressants like meclizine, diazepam, promethazine treat symptoms but can impede compensation and cause sedation.
• D. They are recommended for long-term management.

Answer: (C)

Vestibular suppressants are used in the acute phase to lessen vertigo and associated nausea by dampening vestibular signals. They don’t fix the underlying vestibular problem, so symptoms may improve without treating the root cause. A key limitation is that central compensation—the brain’s process of adapting to abnormal vestibular input—depends on exposure to vestibular signals to recalibrate. Suppressing those signals can slow or blunt this adaptive process, hindering recovery if used for too long. These drugs also commonly cause sedation and slowed reaction times, a particular concern with agents like meclizine and promethazine, and especially with diazepam, which adds dependence risks. For these reasons they’re useful for short-term symptom control but not for long-term management.