ED Management of Vertigo: Dimenhydrinate or Lorazepam?

Anticholinergic agents, antihistamines, benzodiazepines, calcium antagonists, neuroleptics, and glucocorticoids all have been advocated for management of benign positional vertigo. These authors compared 2 of the treatments used most often in the U.S. -- dimenhydrinate (Dramamine) and lorazepam (Ativan) -- in a double-blind, prospective clinical study.

Seventy-four patients with vertigo who presented to one ED over a 4-month period were randomized to receive an intravenous injection of either 2 mg lorazepam or 50 mg dimenhydrinate. Patients rated their sensations of vertigo while walking before treatment and 1 and 2 hours after treatment on a 10-point scale. The lorazepam group had more severe symptoms before treatment than the dimenhydrinat…