For Healthcare Professionals:
Anti-vertigo medications (AVM) such as betahistine are widely used in primary care despite limited evidence of efficacy. A particular concern: a substantial proportion of prescriptions are long-term—even without a clear vestibular diagnosis. A recent study from the Netherlands provides the first systematic data on prevalence and treatment duration in general practice.
Study design:
- Design: Retrospective cohort study (routine data analysis)
- Database: >1.2 million patients from 269 general practices (NL, 2018–2021)
- Inclusion: Adults with vestibular symptoms and/or AVM prescriptions
- Outcomes: Prevalence & duration of AVM prescriptions; predictors of long-term use
Key results
- Of 73,650 patients with vestibular complaints, 6,172 (9.2 %) an AVM prescription.
- Thereof 32 % long-term prescriptions.
- 88% of treated patients did not have Meniere's disease, but Ménière’s was associated with long-term use.
- Older age increased the likelihood of long-term AVM therapy.
- Patients with benign paroxysmal positional vertigo (BPPV) or nonspecific dizziness were less likely to receive long-term prescriptions.
- Urban practices prescribed long-term AVM less frequently.
Conclusion for Practice
- AVM such as betahistine are often prescribed off-label and without a confirmed indication.
- The high proportion of long-term use suggests structural overtreatment especially in cases of nonspecific dizziness or BPPV.
- Vestibular diagnostics and targeted vestibular rehabilitation are still rarely utilized in primary care.
👉 Are you interested in a comprehensive further training in vestibular rehabilitation and its optimal application?
Current further education opportunities can be found in the IVRT Course search.
For Patients – Easy to Understand
Dizziness medication for the long term? Why it often doesn’t help – and what you can do instead
Many people with dizziness receive so-called anti-dizziness medications from their GP — for example, betahistine. A new study from the Netherlands has examined how often these drugs are prescribed and whether they are really useful.
What are the findings?
- Of more than 73,000 patients with dizziness, around 6,000 received an anti-dizziness drug.
- One third of them took it dauerhaft - often without a clear diagnosis such as Meniere's disease.
- Especially older adults were more likely to receive long-term prescriptions.
- Those with mild or positional vertigo (BPPV) were less likely to be prescribed long-term medication.
- In larger cities, doctors tended to prescribe more cautiously.
Why can this be a problem
- or many of these drugs—including betahistine—there is no clear proof of effectiveness.
- They may cause side effects , and the real cause of dizziness often remains unidentified or untreated.
- Especially in BPPV or balance disorders, Repositioning maneuvers and targeted movement therapy ("vestibular rehabilitation") are the treatment of choice.
What you can do
Are you taking dizziness medication regularly?
→ Ask your doctor if the treatment is still necessary.
Get your dizziness properly evaluated — it may be due to a treatable cause such as BPPV .
Specially trained therapists can treat these problems effectively without medication .
f you want to learn more about vestibular rehabilitation and vestibular disorders, check out our Patient information .
These treatment options are offered by our IVRT® dizziness and vestibular therapists .
Conclusion
Dizziness medications are common - but often unnecessary. An accurate diagnosis and targeted training often bring more improvement than pills. Get advice from specialized professionals—for safe and effective treatment.
🎯 Specially trained IVRT® dizziness and vestibular therapists can be found via our IVRT therapist search