The Dizziness Group: For those who are floating, boating, falling or flying

[[La...]]

Kirkhero, it really sounds like withdrawal to me. And since you've done some testing and had "normal" results, it's more likely that it's all down to those little pills that you and I and everyone here took for a little bit too long. 

 

I definitely get bad days where there's push-pull rocking, tinnitus and all the rest, so I can relate to everything you're saying.The way I get through it is by reminding myself that it HAS to end sometime. I just wish I knew when.

Lapis I know this was awhile back. When did the push pulling sensation go away? Did you have the boatiness with pulling? Did anything help during those times?

 

Hi LadyDen,

Push-pull and boatiness are still there for me. The intensity of the symptoms isn't the same every day, but those sensations are the best description I have for what I'm feeling. I suspect that my situation is caused by a combination of factors at this point, which includes the different kinds of meds I took for various lengths of time (benzos for 6.5 years, in combination with either an SNRI or SSRI at various points), as well as perimenopause. I've posted papers on Mal de Debarquement, where they mention the high percentage of women in the affected group -- especially those who are in perimenopause. I wasn't in perimenopause at the beginning of all this, but I sure am now. I recently mentioned another woman that I know whose dizziness symptoms are clearly associated with her ongoing hormonal changes during perimenopause.

 

Obviously, it's very hard to pinpoint what's causing what, but those many papers on Mal de Debarquement (all of which I've posted in this thread) invite many questions for me with regards to what might be happening in my situation. For others, the factors might be quite different, but I can't discount the possible role of changing hormones for me.

 

Everyone is different, and I find that it's best not to do too much comparison. There are genetic factors in each person's situation that have to be taken into account. All I know is that people come and go here on BB, so it's very hard to know who has their symptoms and for how long.

[[La...]]

Ok. Wow. So you having peri menopause has caused yours to remain it seems. Yes everyone is different. I find it amazing that yours isn't gone by now even with peri menopause. I know for certain that mine isn't related to female hormones. But I've read other women's posts that certain times of the month makes their symptoms worse. I certainly hope your boaty- pulling goes away soon for good. You've suffered from it many years now. I want to thank you for being such a powerhouse for the rest of us. I admire your strength and dedication.

I think you missed my question about ear strokes? Have you ever heard about this?

I read that benzo use can cause an ear stroke and it may be the reason for prolonged dizziness, boatiness, push/pulling, ear issues and other balance issues.

Btw I have been getting up to walk a bit more each day. It makes me more boaty afterwards but somehow I've got to make a breakthrough even if it's small.

[[La...]]

Hi LadyDen,

I have no idea what "ear strokes" are. Do you have a definition or a description? Never heard of it!

[[La...]]

Ear strokes are strokes that occur in the ear. It mostly manifest with sudden hearing loss mainly in one ear. Within 3 days you lose part or all of your hearing along with sudden dizziness, tinnitus and ear ache. Most people mistake this for wax buildup or allergies causing the ear to feel full like being underwater. It can be caused by blood supply not getting to the ear properly due to blood pressure, blocked artery, ear infections, medication adverse reaction,etc. If it's not treated immediately most of the cases are permanent hearing loss in the affected ear.

[[La...]]

Ear strokes are strokes that occur in the ear. It mostly manifest with sudden hearing loss mainly in one ear. Within 3 days you lose part or all of your hearing along with sudden dizziness, tinnitus and ear ache. Most people mistake this for wax buildup or allergies causing the ear to feel full like being underwater. It can be caused by blood supply not getting to the ear properly due to blood pressure, blocked artery, ear infections, medication adverse reaction,etc. If it's not treated immediately most of the cases are permanent hearing loss in the affected ear.

 

Okay, well, I certainly haven't heard of anyone having that during my time here on BB -- thank goodness! It's one more reason why I believe people should get things properly assessed by a doctor before assuming that all of their symptoms are caused by benzos.

[[La...]]

Actually, I was just going to post this medical study about dizziness and diagnoses. It gives us a sense of how many different types of dizziness there are. It's called "Patients with vertigo/dizziness of unknown origin during follow-ups by general otolaryngologists at outpatient town clinic". The question remains....Where would we fit in here?

 

https://pubmed.ncbi.nlm.nih.gov/33023775/ 

 

Abstract

 

Objectives: The purpose of this study was to access the contribution of vertigo/dizziness-related patients' interview and examinations during short-term hospitalization in determining the accurate final diagnosis of vertigo/dizziness of unknown origin.

 

Methods: We reviewed 1905 successive vertigo/dizziness patients at the Vertigo/Dizziness Center of Nara Medical University, who were introduced from general otolaryngologists at outpatient town clinic from May 2014 to April 2020. However, 244 patients were diagnosed with vertigo/dizziness of unknown origin (244/1905; 12.8%). Of these patients, 240 were hospitalized and underwent various examinations, including caloric test (C-test), video head impulse test (vHIT), vestibular evoked cervical myogenic potentials (cVEMP), subjective visual vertical (SVV), inner ear magnetic resonance imaging (ieMRI), Schellong test (S-test), and self-rating questionnaires of depression score (SDS).

 

Results: According to the examination data, together with interviewed vertigo/dizziness characteristics and daily changeable nystagmus findings, the final diagnoses were as follows: benign paroxysmal positional vertigo (BPPV: 107/240; 44.6%), orthostatic dysregulation (OD: 56/240; 23.3%), vestibular peripheral disease (VPD: 25/240; 10.4%), vestibular migraine (VM: 14/240; 5.8%), Meniere's disease (MD: 12/240; 5.0%), gravity perception disturbance (GPD: 10/240; 4.2%), psychogenic vertigo (Psycho: 10/240; 4.2%), and unknown (Unknown: 6/240; 2.5%). Supporting factors of final diagnosis was seen in gender, evoked dizziness, and positional nystagmus as BPPV; in evoked dizziness, S-test, and hypertension as OD; in evoked dizziness, head shaking after nystagmus, C-test, and vHIT as VPD; in gender, headache, and S-test as VM; in ear fullness and ieMRI as MD; in gender, evoked dizziness, and SVV as GPD; and in SDS as Psycho. To sum up, the ratios of Unknown were significantly reduced by this short-term hospitalization (244/1905→6/240).

 

Conclusions: The answer lists for vertigo/dizziness of unknown origin obtained in the present study may be helpful for future general otolaryngologists at outpatient town clinic to better attain an accurate final diagnosis.

 

 

[[La...]]

Thx Lapis. Very interesting.

[[Mi...]]

For us dizzy people... I'm going to cut out sugar now. Not fruit, but I don't eat a lot of fruit. But that one to two caffiene free, non diet pop I have per day ...  and sometimes a few cookies, I'm going to cut them out.

 

Drinking pop is straight concentrated sugar. I want to see if my feeling boaty issues lessen in doing this.

[[La...]]

In my case, I don't eat any sugar at all. And I would never cut out fruit, since it's an excellent source of vitamins, minerals, fibre and energy.

 

I used to read some of the threads on this diet or that diet here on BB, but I gave up on trying to follow any of it. We all need to eat in a healthy way, but what that means to different people varies widely. Everyone has to figure out what works for him- or herself.

 

 

[[La...]]

I totally agree. I experimented with diet changes/eating the same EXTREMELY clean meal for several weeks in a row......it didn't make any difference in my waves/windows. They came when it was time and went when it was time.

But I will say consuming less sugar is healthy overall. It might help a bit to reduce your sugar intake or it may not. I agree with Lapis that you should not eliminate fruit. Your body needs a healthy balance.

[[La...]]

I will just add to the discussion on fruit and sugar: Fruit -- whole fruit -- does provide sugar, but its absorption into the digestive system is slowed by the presence of fibre (fiber, for the Americans among us!). Juice, however, is just like sugar, and it's best avoided. There's no fibre.

 

If you've ever heard of the glycemic index, it's a chart that divides all kinds of foods by how closely they mimic sugar in the body. The lower the score, the slower the effect on the blood sugar. In general, complex carbohydrates tend to be absorbed more slowly (think of whole grains like quinoa, whole or steel-cut oat and whole barley, and legumes like lentils, chickpeas and black beans). White bread, white flower and white potatoes tend to be higher in the glycemic index.

 

https://www.diabetes.ca/managing-my-diabetes/tools---resources/the-glycemic-index-(gi) 

 

 

 

 

[[Mi...]]

Thank you for your replies.

 

I do eat more fruit than I had been. Bananas, apples and almonds, brown rice, because my potassium was just a very tad low. Once I did that I actually felt better. The nutrients vitamins & fiber are so important. You're very right.

[[La...]]

Thank you for your replies.

 

I do eat more fruit than I had been. Bananas, apples and almonds, brown rice, because my potassium was just a very tad low. Once I did that I actually felt better. The nutrients vitamins & fiber are so important. You're very right.

 

Hey, that's great, Miss Fortitude! 

[[Th...]]

Hi all,

 

I do not visit BB too often anymore but now I found old very interesting post. In my case I got lot of relief to my dizziness by exercising. First I walked a little and then gradually increased all kind of balance supporting movements under supervision of my PT. First day 5 minutes, then 10 minutes etc.

 

I fully believe we can teach our brains and impact to dizziness as well. Link to old post from cupcake.

 

http://www.benzobuddies.org/forum/index.php?topic=20556.msg310855#msg310855

 

 

Thomas

[[La...]]

Thx Thomas for that valuable information. I agree with you. I've been bedridden because of the boatiness/ pulling dizziness. Today I thought since I can't walk around much what can I do? I can sit in a chair for 15-20 minutes if the chair is flat without a cushion. So it dawned on me to look for chair exercises low impact. I found chair yoga for seniors, reconditioning bedridden people or people with disabilities that won't allow them to walk. I was able to do this very easily with almost no bad reactions except my boatiness is slightly increased with ear ringing a little louder. I'm a bit tired from it because I've been bedridden so long. But I'm so happy that I'm crying! Here's a link for whoever wants to do them. What a milestone for me! 

https://youtu.be/HEhfEyAgPv0

[[Th...]]

Thx Thomas for that valuable information. I agree with you. I've been bedridden because of the boatiness/ pulling dizziness. Today I thought since I can't walk around much what can I do? I can sit in a chair for 15-20 minutes if the chair is flat without a cushion. So it dawned on me to look for chair exercises low impact. I found chair yoga for seniors, reconditioning bedridden people or people with disabilities that won't allow them to walk. I was able to do this very easily with almost no bad reactions except my boatiness is slightly increased with ear ringing a little louder. I'm a bit tired from it because I've been bedridden so long. But I'm so happy that I'm crying! Here's a link for whoever wants to do them. What a milestone for me! 

https://youtu.be/HEhfEyAgPv0

 

👍👍👍 LadyDen!

[[Mi...]]

Thx Thomas for that valuable information. I agree with you. I've been bedridden because of the boatiness/ pulling dizziness. Today I thought since I can't walk around much what can I do? I can sit in a chair for 15-20 minutes if the chair is flat without a cushion. So it dawned on me to look for chair exercises low impact. I found chair yoga for seniors, reconditioning bedridden people or people with disabilities that won't allow them to walk. I was able to do this very easily with almost no bad reactions except my boatiness is slightly increased with ear ringing a little louder. I'm a bit tired from it because I've been bedridden so long. But I'm so happy that I'm crying! Here's a link for whoever wants to do them. What a milestone for me! 

https://youtu.be/HEhfEyAgPv0

 

👍👍👍 LadyDen!

 

Omg! I luv this! Any kind of exercise with dance is great! Thank you for sharing!

 

I have noticed that when I dance, I move better and have less boatiness and less balance issues. Dancing is healthy in so many ways!

[[La...]]

Hi Dizzy Buddies,

I'm still regularly checking out PubMed to see what the latest studies are saying, and I came across one yesterday that speaks to an issue I've brought up a number of times, i.e. female hormones and dizziness. This particular study looks at dizziness in pregnant women. Thankfully, I was able to access the full study, and I'm going to post the abstract, plus the introduction, discussion and conclusion for this one. You'll see that not only hormones are mentioned as factors in dizziness (i.e. not just during pregnancy), but also neurotransmitters. Yes, that's what we're often talking about here on BB, since benzos are known for their strong effect on GABA-A and their receptors.

 

Here it is:

 

"Assessment of otolith function using vestibular evoked myogenic potential in women during pregnancy"

 

https://pubmed.ncbi.nlm.nih.gov/33067134/

 

Abstract

 

Introduction: More than 50% of pregnant women experience dizziness frequently in the first two gestational trimesters. During pregnancy, the changes in the metabolism of hormones are responsible for the ovarian cycle resulting in either peripheral or central vestibular alterations. The need for the study is to focus on the effect of changes during pregnancy on the vestibular evoked myogenic potential, an electrophysiological measure that investigates functions of the otolith structures.

 

Objectives: The aim is to investigate the vestibular evoked myogenic potential responses during the first trimester of pregnancy.

 

Methods: A total of 17 pregnant women and 17 non-pregnant women with age matched took part in this study. The cervical vestibular evoked myogenic potential were recorded from the ipsilateral sternocleridomastoid muscle and the ocular vestibular evoked myogenic potential were recorded from contralateral extraocular muscle in both groups.

 

Results: Peak to peak amplitude of cervical vestibular evoked myogenic potential and ocular vestibular evoked myogenic potential was found to be significantly reduced in the responses obtained from first-trimester pregnant women when compared to that of non-pregnant women.

 

Conclusions: Vestibular evoked myogenic potential tests exhibits a clinically significant reduced peak to peak amplitude in the first trimester of pregnancy, which indicates dysfunction in the otolith reflex pathway.

 

Full Study:

 

https://www.sciencedirect.com/science/article/pii/S1808869420301506?via%3Dihub 

 

Introduction

 

Pregnancy induces various physiological changes in almost all organ systems. Crucial changes exhibited during pregnancy include intracellular and extracellular fluid changes, osmolality changes, and alterations in the immune system. These changes in pregnancy may have impacts on cochlear microcirculation and fluid balance in the cochlea, which may alter hearing sensitivity.1, 2 3 The symptoms are often associated with the action of estrogen and progesterone on the cochlea,Changes in the metabolism of steroid hormones (estrogen and progesterone), responsible for the ovarian cycle can also result in either peripheral or central vestibular alterations, which may occur during the normal menstrual cycle, gestation, menopause and the pre-menstrual periods. posterior labyrinth, and central auditory pathways with hearing and balance alterations, which are clinically referred to as vertigo, instability, tinnitus, ear fullness, or hyperacusis.3, 4 More than 50% of pregnant women experience dizziness which occurs more frequently in the first two gestational trimesters. The hormonal alteration during pregnancy leads to possible vestibular alterations resulting in dizziness associated with nausea during the first gestational trimester, and this complaint diminishes in the following trimesters because of labyrinthine habituation.3 And there is very limited evidence that explains the effects of hormonal changes during pregnancy on the otolithic organs of the vestibular system.

 

To investigates the functions of the otolithic structures, inferior,5, 6 and the superior branch of the vestibular nerve7 an electrophysiological measure vestibular evoked myogenic potential (VEMP) is used. The VEMPs responses are obtained from the otolithic organs, the utricle, and the saccule, through the vestibulo-ocular and vestibulo-collic reflexes respectively.8 The vestibulo-collic reflex responses are obtained from cervical VEMP testing (cVEMP) having its origin in the vestibular saccule further carried by the inferior vestibular nerve and finally synapsing at the sternocleidomastoid muscle.9, 10 The vestibulo-ocular reflex pathway responses are acquired from ocular VEMP testing (oVEMP) which is presumed to have its origin from the utricle.11 The pathway is thus thought to travel from the utricle, passing through the superior vestibular nerve, vestibular nucleus, then crossing over to the contralateral oculomotor nuclei via the medial longitudinal fasciculus and finally innervating the extraocular muscles.8 As there was prevailing evidence of physiological and metabolic changes in pregnant women within the vestibular function, there is a need to provide an insight into the effects of changes during pregnancy on the VEMP recordings. Hence, the present study aims to investigate the VEMPs responses during the first trimester of pregnancy. The first objective of the study is to compare cVEMP responses among pregnant women and non-pregnant women, and the second objective is to compare oVEMP responses between the two same groups.

 

 

----------------------------------------------

 

Discussion

 

This study revealed that the peak to peak amplitude of cVEMP and oVEMP responses was found to be significantly reduced in the first trimester pregnant women when compared to that of non-pregnant women. The reviews on test-retest reproducibility studies showed that peak to peak amplitude of VEMP responses seems to have good significance.13, 14 In the present study, the reduction in peak to peak amplitude of VEMPs in pregnant women may be due to alterations in the otolithic organ, and such alterations in the vestibular system can be attributed to the hormonal milieu changes that occur during pregnancy. Supporting the findings of the present study, there is literature showing that the neurotransmitters released during pregnancy can alter the biochemical control of the inner ear, which possibly triggers an increase in neurotological symptoms.3 Such a fact can be responsible for the frequent complaint of dizziness during pregnancy. During pregnancy, the levels of both ovarian hormones are higher than usual, and there can be signs of other complex physiological changes also.15 The receptors present in the spiral ganglion and the hair cells (OHC and IHC’s) theorize that estrogen may affect the auditory transmission, whereas the fluid-electrolyte balance in the cochlea is affected by the receptors in the stria vascularis.16 Progesterone is an ovarian hormone emanated during the luteal phase of the ovarian cycle by the corpus luteum, which acts as a neurosteroid and forms a progenitor to other steroid hormones.17 Progesterone along with its metabolites may also affect the auditory system when it interacts with the steroid-binding sites as GABA-A antagonists on the GABA-A receptors.18 Thus, in general, progesterone is mainly found to have an inhibitory action on the CNS, counteracting the estrogen’s excitatory action, leading to a balance in the auditory system.

Schmidt et al., had reported that 52.44% of women had dizziness during pregnancy among which the highest (63.64%) occurrence was observed during the first trimester followed by second (60.61%) trimester. During the third trimester, dizziness was reported to be present in only 33.33% in pregnant women. The symptom of vestibular alteration can be due to the hormonal changes and the reduction in the symptom in the following trimesters happens due to labyrinthine habituation.3 Another study reports that vestibular alteration normalizes throughout the gestational period which may be attributed to the labyrinthine habituation.19 Nausea and vomiting during pregnancy occurs in 85% of pregnant women, with varying degrees of severity having been reported.20 On the other hand, another study suggested that the etiology is unknown but most likely to be multi-factorial, such as hormonal alternation, thyroid disorders, vitamin deficiency, etc. Effects of pregnancy on Meniere’s disease report that vertigo attack increased up to ten times per month during early pregnancy because of significantly reduced serum osmolality which normalizes in the following trimesters.21

 

In the present study, the reduction in VEMPs amplitude suggestive of peripheral labyrinthine dysfunction. The literature reveals that, during pregnancy, there are hormonal abnormalities or changes which act as a predisposing factor for dizziness. During the menstrual cycle, gestation, and menopause there are hormonal alterations that cause various homeostatic, metabolic effects. Numerous theories have been proposed concerning estrogen effects. The estrogen receptors have been identified, mainly in the spiral ganglion and stria vascularis, which are important in hearing transmission and inner ear homeostasis.22 There is evidence stating that estrogen affects endolymph ionic and anionic homeostasis by regulating ion and anion channels.23, 24 Alteration in estrogen causes otoconial degeneration and detachment leading to positional vertigo.16

Conclusion

 

The results of this investigation have shown reduced peak to peak amplitude during the first trimester of pregnancy. The reduction in amplitude has been observed in of cVEMP and oVEMP. The reduction in amplitude indicates dysfunction in the otolith reflex pathway. As pregnant women usually have vestibular complaints, VEMP can be used as a clinical tool for investigation and further monitoring can be done if necessary.

 

 

[[La...]]

Miss & Thomas you're very welcome. I'm loving it! It's helping me so much. I hope it helps you too. I'm barely boaty at all when I'm doing chair yoga. Unbelievable!

[[La...]]

Hi Dizzy Buddies,

There's another study that recently came out on Mal de Debarquement Syndrome. It's the syndrome whose symptoms seem closest to what most of us are experiencing -- in particular, the sensation of being on a boat. Some people have "motion-triggered" symptoms, e.g. boat, plane or car travel, and others have what has been referred to as "spontaneous" or "other" onset. Obviously, for those of us around here, the latter description fits.

 

This study is called "The Interconnections of Mal de Débarquement Syndrome and Vestibular Migraine", and I can say that I've certainly come across other studies with mentions of migraines. I never get headaches, so I can't relate, but I do know that other BBs who have dropped in on this thread have had them.

 

Anyway, if you're interested, you can have a look at the abstract for this study here:

 

https://pubmed.ncbi.nlm.nih.gov/33135784/ 

 

Abstract

 

Objectives/hypothesis: Mal de débarquement syndrome (MDDS) is characterized by a persistent rocking sensation, as though on a boat. It may occur following exposure to passive motion (motion-triggered MDDS [MT-MDDS]), or spontaneously (spontaneous-onset MDDS [sO-MDDS]). This study investigated the characteristics of MDDS patients with vestibular migraine (MDDS-VM) to those without (MDDS-O).

 

Study design: Retrospective review.

 

Methods: Retrospective, single-center study of 62 patients with MDDS. Clinical characteristics, Dizziness Handicap Inventory (DHI), Migraine Disability Assessment Score (MIDAS), job impact, and optimal treatment(s) were studied.

 

Results: There were 23 MDDS-O (19 women), and 39 MDDS-VM (35 women) patients. Comparisons between MDDS-VM and MDDS-O showed significant differences in age of onset (41 vs. 52 years, P = .005), interictal visually induced dizziness (89.7% vs. 30.4%, P < .001), interictal head motion-induced dizziness (87.2% vs. 47.8%, P = .001), other vestibular sensations (59% vs. 13%, P < .001), interictal aural symptoms (25.6% vs. 0%, P = .008), number of interictal symptoms (4.3 vs. 2.3, P < .001), total DHI score (54.9 vs. 38.1, P = .005), DHI-P (physical domain) score (16.1 vs. 10, P = .004), DHI-F (functional domain) score (20.9 vs. 15.7, P = .016 MIDAS (4.6 vs. 32, P = .002), and job resignations (23.2% vs. 5%, P = .016). On the other hand, between-group comparisons for MT-MDDS and SO-MDDS did not reveal any significant differences whatsoever. For optimal treatment, venlafaxine was the most used (27.3%) in all groups. For MDDS-VM, antiepileptic drugs and migraine preventive vitamins were also useful in relieving symptoms.

 

Conclusions: MDDS-VM patients appear to be more disabled than MDDS-O, in terms of severity of dizziness, job impact, and number of symptoms, but have good potential for improvement, particularly with migraine prophylactic treatment.

[[La...]]

Lapis I read that and I was like wow it describes what I have but I sure didn't get it from a real boat ride, car ride etc. 1000% Ambien did it! Thx for the post. Chair yoga is going well.

[[La...]]

Lapis I read that and I was like wow it describes what I have but I sure didn't get it from a real boat ride, car ride etc. 1000% Ambien did it! Thx for the post. Chair yoga is going well.

 

Yes, there are two kinds of MdDS -- "motion-triggered" and "sponataneous" or "other". Ours would obviously be the latter type.

 

Glad you're doing well with the chair yoga. 

 

I've been doing a set of exercises (bed, chair, etc.) for quite awhile now. I'd be completely insane without it. It's important to try to keep moving, I believe.

[[...]]

Just joining this group as I have a fair amount of dizziness from my benzo withdrawals. I hope to find some good info. 

[[La...]]

SRR I'm sure you will find great info here. Welcome

[[La...]]

Hi Everyone,

I just wanted to re-post this link to a page from an organization that focuses on dizziness. This particular page looks at medications and what role they play. Here's the first part of the page, where they mention "vestibular suppressants", like anticholinergics, anthihistamines and benzodiazepines. As per the article, they're not appropriate for long-term use because they make the brain "sleepy". I've highlighted the last paragraph, where they say that "symptoms must be actively experienced without interference in order for the brain to adjust"....

 

 

https://vestibular.org/article/diagnosis-treatment/treatments/medication/ 

 

 

Article Summary

 

The use of medication in treating vestibular disorders depends on whether the vestibular system dysfunction is in an initial or acute phase (lasting up to 5 days) or chronic phase (ongoing).

 

During the acute phase, and when other illnesses have been ruled out, medications that may be prescribed include vestibular suppressants to reduce motion sickness or anti-emetics to reduce nausea. Vestibular suppressants include three general drug classes: anticholinergics, antihistamines, and benzodiazepines. Examples of vestibular suppressants are meclizine and dimenhydinate (antihistamine-anticholinergics) and lorazepam and diazepam (benzodiazepines).

 

Other medications that may be prescribed are steroids (e.g., prednisone), antiviral drugs (e.g., acyclovir), or antibiotics (e.g., amoxicillin) if a middle ear infection is present. If nausea has been severe enough to cause excessive dehydration, intravenous fluids may be given.

 

During the chronic phase, symptoms must be actively experienced without interference in order for the brain to adjust, a process called vestibular compensation. Any medication that makes the brain sleepy, including all vestibular suppressants, can slow down or stop the process of compensation. Therefore, they are often not appropriate for long-term use. Physicians generally find that most patients who fail to compensate are either strictly avoiding certain movements, using vestibular suppressants daily, or both.