Vertigo - Treatment 

Treating vertigo 

Driving and vertigo

Vertigo could affect your ability to drive. You should avoid driving if you've recently had episodes of vertigo and there's a chance that you may have another episode while you're driving.

It is your legal obligation to inform the Driver and Vehicle Licensing Agency (DVLA) about a medical condition that could affect your driving ability. See the GOV.UK website for more information.

Treatment for vertigo will depend on the cause and severity of your symptoms.

During a vertigo attack, lying still in a quiet, darkened room may help to ease any symptoms of nausea that you have and reduce the sensation of spinning. You may be advised to take medication during this time.

You should also try to avoid stressful situations, as anxiety can make the symptoms of vertigo worse.


Labyrinthitis is an inner ear infection that causes the labyrinth (a delicate structure deep inside your ear) to become inflamed. It's usually caused by a viral infection and clears up on its own without treatment. In rare cases where labyrinthitis is caused by a bacterial infection, antibiotics may be prescribed.

If you have experienced any hearing loss, your GP may refer you to an ear, nose and throat (ENT) specialist or an audiovestibular physician. This is a doctor who specialises in hearing and balance disorders. You may need emergency treatment to restore your hearing.

Labyrinthitis may also be treated with vestibular rehabilitation, also called vestibular rehabilitation training or VRT.

See treating labyrinthitis for more information.

Vestibular neuronitis

Vestibular neuronitis, also known as vestibular neuritis, is inflammation of the vestibular nerve (one of the nerves in your ear that's used for balance). It's usually caused by a viral infection.

The symptoms of vestibular neuronitis often get better without treatment over several weeks. However, you may need to rest in bed if your symptoms are severe. See your GP if your symptoms get worse or don't start to improve after a week.

You may find that your balance is particularly affected if you:

  • drink alcohol
  • are tired
  • have another illness as well

Avoiding these can help improve your condition.

Vestibular neuronitis can also be treated with vestibular rehabilitation and medication.

Benign paroxysmal positional vertigo (BPPV)

Like vestibular neuronitis, benign paroxysmal positional vertigo (BPPV) often clears up without treatment after several weeks or months. It's thought the small fragments of debris in the ear canal that cause vertigo either dissolve or become lodged in a place where they no longer cause symptoms. BPPV can sometimes recur.

Until the symptoms disappear or the condition is treated, you should:

  • get out of bed slowly
  • avoid activities that involve looking upwards, such as painting and decorating or looking for something on a high shelf

BPPV can be treated using a procedure called the Epley manoeuvre.

The Epley manoeuvre

The Epley manoeuvre is a type of procedure called a canalith repositioning procedure. It is often effective in resolving the symptoms of vertigo.

The Epley manoeuvre involves performing four separate head movements to move the fragments that cause vertigo to a place where they will no longer cause symptoms. Each head position is held for at least 30 seconds. You may experience some vertigo during the movements.

In the past, patients were given instructions to follow after performing the Epley manoeuvre, such as not lying flat for 48 hours. However, this is now considered unnecessary.

Your symptoms should improve shortly after the Epley manoeuvre is performed, although it may take up to two weeks for a complete recovery. Return to your GP if your symptoms haven't improved after four weeks. The Epley manoeuvre isn't usually a long-term cure and may need to be repeated.

Brandt-Daroff exercises

If the Epley manoeuvre doesn't work or if it's not suitable – for example, because you have neck or back problems – you can also try Brandt-Daroff exercises. These are a series of movements you can do unsupervised at home to treat BPPV.

Your GP will need to teach you how to do the exercises. You repeat them three or four times a day for two days in a row. Your symptoms may improve for up to two weeks.

Referral for BPPV

Your GP may refer you to a specialist, such as an ear, nose and throat (ENT) specialist if:

  • the Epley manoeuvre doesn't work or can't be performed
  • you still have symptoms after four weeks
  • you have unusual signs or symptoms

In rare cases, where the symptoms of vertigo last for months or years, surgery may be recommended. This may involve blocking one of the fluid-filled canals in your ear. Your ENT specialist will be able to advise you further about this.

Ménière's disease

If your vertigo is caused by Ménière's disease (a rare condition that affects the inner ear), there are a number of treatment options for both the vertigo and other symptoms caused by the condition.

Possible treatments for Ménière's disease include:

  • dietary advice, particularly a low salt diet
  • medication to treat attacks of Ménière's disease
  • medication to prevent attacks of Ménière's disease
  • treatment for tinnitus (ringing in your ears), such as sound therapy, a therapy that works by reducing the difference between tinnitus sounds and background sounds to make the tinnitus sounds less intrusive
  • treatment for hearing loss, such as using hearing aids
  • physiotherapy to deal with balance problems
  • treatment for the secondary symptoms of Ménière's disease, such as stress, anxiety and depression

See treating Ménière's disease for more information.

Central vertigo

Central vertigo is caused by problems in part of your brain, such as the cerebellum (which is located at the bottom of the brain) or the brainstem (the lower part of the brain that's connected to the spinal cord).

Causes of central vertigo include migraine headaches and, less commonly, brain tumours.

If your GP suspects you have central vertigo, they may organise a scan or refer you to a hospital specialist, such as a neurologist or an ENT (ear, nose and throat specialist) or audiovestibular physician.


You can be treated at home if you've already been diagnosed with vertigo caused by migraines. The condition may be treatable with the same medications used to control migraines, such as triptans.

See treating migraines for more information.

Vertigo with an unknown cause

If the cause of your vertigo is unknown, you may be admitted to hospital if:

  • you have severe nausea and vomiting and can't keep fluids down
  • your vertigo comes on suddenly and was not caused by you changing position
  • you possibly have central vertigo
  • you have sudden hearing loss but it's not thought to be Ménière's disease

Alternatively, you may be referred to a specialist such as:

  • a neurologist – a specialist in treating conditions that affect the nervous system
  • an ENT specialist – a specialist in conditions that affect the ear, nose or throat
  • an audiovestibular physician – a specialist in hearing and balance disorders

While waiting to see a specialist, you may be treated with medication. 

Vestibular rehabilitation

Vestibular rehabilitation, also called vestibular rehabilitation training or VRT, is a form of "brain retraining". It involves carrying out a special programme of exercises that encourage your brain to adapt to the abnormal messages sent from your ears.

During VRT you keep moving despite feelings of dizziness and vertigo. Your brain should eventually learn to rely on the signals coming from the rest of your body, such as your eyes and legs, rather than the confusing signals coming from your inner ear. By relying on other signals, your brain minimises any dizziness and helps you maintain your balance.

An audiologist (hearing specialist) or a physiotherapist may provide VRT. Your GP may be able to refer you for VRT, although it will depend on availability in your area.

In some cases, it may be possible to use VRT without specialist help. Research has shown people with some types of vertigo can improve their symptoms using a self-help VRT booklet. However, you should discuss this with your doctor first. If it is likely to be useful, you can download a copy of this booklet from the Ménière's society.


Medication can be used to treat episodes of vertigo caused by vestibular neuronitis or Ménière's disease. It may also be used for central vertigo or vertigo with an unknown cause.

The medicines are usually prescribed for 3 to 14 days, depending on which condition they're for. The two medicines that are usually prescribed are:

  • prochlorperazine
  • antihistamines

If these medicines are successful in treating your symptoms, you may be given a supply to keep at home so you can take them the next time you have an episode of vertigo.

In some cases you may be advised to take long-term medication, such as betahistine, for conditions like Ménière's disease.


Prochlorperazine can help relieve severe nausea and vomiting associated with vertigo. It works by blocking the effect of a chemical in the brain called dopamine.

Prochlorperazine can cause side effects, including tremors (shaking) and abnormal or involuntary body and facial movements.

It can also make some people feel sleepy. For the full list of possible side effects, check the patient information leaflet that comes with your medicine or see prochlorperazine medicines information.

If you're vomiting, there are some types of prochlorperazine that dissolve on your tongue so you don't have to swallow any tablets. It can also be administered as a suppository (a medication inserted into the rectum).


Antihistamines can be used to help relieve less severe nausea, vomiting and vertigo symptoms. They work by blocking the effects of a chemical called histamine.

Possible antihistamines that may be prescribed include:

Like prochlorperazine, antihistamines can also make you feel sleepy. Headaches and an upset stomach are also possible side effects. Check the patient information leaflet that comes with your medicine for the full list of possible side effects.

A medication called betahistine works in a similar way to antihistamines. It has been used to treat Ménière's disease and may also be used for other balance problems. It may have to be taken for a long period of time. The beneficial effects vary from person to person.

Page last reviewed: 06/03/2013

Next review due: 06/03/2015


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The 6 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Nurture1 said on 30 October 2014

My husband has Chronic vertigo due to peripheral dysfunction for over 15 years. I am adding this dramatic major improvement that has been achieved by using (Metoclopramide, 10 mg x3 per day). Thanks to the A&E at North Mid hospital, it's been a godsend for us both. But he still has nausea and dizziness on waking but major reduction on symptoms.

For 3 years he was taking Kwells: (Hyoscine Hydrobromide) travel sickness tablets. This allowed him to sit in his chair and use computer, with about 6 hours relief per day, but he cannot walk more than a few yards without fear of dizziness. He has ginger tea twice a day and ginger chews to combat the sickness.

He attends ENT every 6 months or so. But currently waiting for months to get a scan while seated so he can get an appt.with a Neurollogist at UCLH. His current symptoms are chronic, dizziness, vomiting and tinnitus occurring daily from waking and throughout the day with it subsiding around mid evening, but not enough for him to be able to lead a normal life. He experiences extreme dizziness as soon as he lays his head back as well as just trying to do normal tasks . So he sleeps in his chair until exhausted he may lay on his side by 5.00 am in morning until he can rise again very slowly in the afternoon. Memory and attention span limited. He appears to be affected by the air pressure outside. Prior to stormy or severe temperature changes he has severe attacks.
He has tried these amongst other drugs: Prochlorprazine (Stemetil) Some relief for up to 4 hours, but severe reaction with withdrawal, regularly requiring ambulance.
Fluticasone Furoate (Avamys) Nasal Spray.: Bad reaction within 30 mins brought on extreme reaction and Chronic a Vertigo Attack .
Betahistine: Worsening of condition experienced. .
I hope this note it may help others who are suffering from these debilitating vertigo symptoms.

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Kzin said on 02 December 2013

My grandpa has had vertigo many years. First got dizzy all the time and then lost his hearing. We had the best results with homeopathy and some advanced natural remedies like OM10 VRT and Prana Mana and Bee Pollen Liquescence. He doesn't get dizzy spells anymore and hearing is much better too.

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MikeUsa said on 27 December 2012

tigarlily hi I have experience similar symptoms which includes dizziness, vertigo, vomiting, excessive mucus, floor bouncing, walls moving, numbness in hands and feet for the past 3 to 5 years on and off. I work in and office building in nyc doing computer work. After many tests mri head and spine, EEG, blood tests, with my dr and neurologist who did understand what happened to me. Thought I was diabetic or something which my blood tests always came out fine.
I did figured out what was causing all of my health issues and May be the same in your case.
Turns out that the mta subway transit was tunneling for years with tunnel boring machines and mining equipment digging through rock 24/7. These vibrations cause buildings to vibrate and move continuously, bouncing floors which can cause head, neck and spin injuries which is what I had over time and was getting worse. Try to find out if this type of work is going on where you live or work. Also check for high levels of ammonia in your blood work.

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tigarlily said on 12 December 2012

Hi I was wondering if anyone could possibly help me, Over the past 2 years i have been having frequent attacks of what i think could be vertigo. Im saying i think I have been to 6 doctors who say that they do not know what my condition is and that it maybe something that i will never know,My symptoms include dizziness vomiting/nausea light headedness numbness walking to the right side and can not seem to walk straight feeling very faint and in some cases I have fallen but not passed out. I have a feeling of the walls closing in on me I see them breathing! very fuzzy, I also suffer from servere migrains but not at the same time as these attacks,
The attack accure for average 20minuites sometimes longer i have to lie down and I have the feeling of weakness for upto 5 hours after the initial attack. other attack can re-accure every 2-3 days and sometimes i dont have an attack for 3-4 weeks. I have no warning they just happen i can bewalking 1min and the next be on the floor, i can be sat down, and not realy moving and i have one, i dont recall my hearing been effected but to be honest thats not what im concerned about, Iam scarred, i feel like my life has been limited to the things i used to do, Im not old or young just middle aged and i dont want to have to suffer from this thing that i dont even know what it is called or what i can take to try to prevent it. I do hope someone can spread some light on this matter that is tearing me up.

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moirab said on 01 September 2012

Hi. Does anyone know if ME and Vertigo are linked? My husband was diagnised with labrynthites, then after a few months was changed to be ME. His dizzieness has got worse over the last month or so.

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Sreeni_V said on 25 May 2012

Hai , Can some one advise how do I differentiate between BPPV and Labyrinthitis.

I had dizziness for almost 2 week after I had stomach bug and the first GP said it was due to inner ear inflammation and second GP said BPPV.

I dont know how to know whether it is one of them or not.
any advise please.

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If you have vertigo, there are some safety issues that you should consider. For example:

  • you should inform your employer if your job involves operating machinery or climbing ladders
  • you may be at increased risk of falls – see preventing falls for advice about making your home safer and reducing your risk

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