Joe, don’t give up on meds. While our bodies are incredible biomechanical machines, they often need a little help with the chemistry as they age.
I don’t have PPPD, but my experience with Vestibular Migraines told me that you will have to keep close watch on how your body reacts to the meds, and let the docs know if they have side effects that are unbearable.
You will most likely have to try several different meds to find the right combination to give you the help you need.
The main thing is, don’t give up. A normal life is worth the fight, and medications and balance exercises are the keys to that normal life.
It’s not easy, but most things worthwhile aren’t easy.
Vestibular disorders can be very difficult to diagnose due to similarity of symptoms. The rocking/ swaying of 3PD can be very similar to VM, MdDS and other vestibular dysfunction. Normally 3PD follows after a vestibular assault, like an infection, neuritis, a bout of BPPV, a vestibular migraine. Its believed the brain doesnt properly compensate after your balance system has undergone a mauling and still believes it is compromised.
Or in some cases after a prolonged period of anxiety or stress or a panic attack. However there are strong indications that many people with 3PD have a history orfamily history of migraine, so it could be 3PD is just another manifestation of migraine.
Have you had any tests done? Its important to rule out other vestibular conditions. 3PD is a diagnosis of exclusion essentially, that other conditions have been ruled out.it could be 3PD but it could be VM or an inner ear defect.
SSRI’s are often prescribed for 3PD but there isnt a lot of evidence that they work, however anxiety and low mood certainly wont help and could contribute towards your symptoms. The other thing that is often recommended for 3PD is vestibular physiotherapy, exercises that strengthen the balance system and help the brain and eyes work together properly again. You could either try and find one or look on Youtube, there are loads of free videos.
The Steady Coach offers free videos and courses for anyone suffering with chronic dizziness/ dysequilibrium.
I’ve resisted the SSRIs because I’d rather try to find medication to help/cure. Was on Cinarizine but now on Betahistine but not noticed any improvements with either. Still get the rocking in my head daily, dizziness, head feeling woozy and headaches. Hope you can find something to help you asap!
The escitalopram I took for how my anxiety was increasing things. That helped me from freaking out which in turn didn’t cause me to increase the dizziness I already had.
Nortriptyline in specific was what was prescribed by my neuro-oto. That one is a tricyclic. Tricyclics are usually not used too frequent due to the side effects. My neuro describes them as a “dirty drug”. It works on so many fronts that it doesn’t exactly tell you which front is the one that really needs to be fought. It’s like dropping a nuke on enemies coming from the west instead of just sending reinforcements to the west.