Comparison of Intraveneous Diazepam, Dimenhydrinate and Diphenhydramine on Patients with Acute Peripheral Vertigo in the Emergency Department: A Randomized, Double Blind, Clinical Trial

Objectives: The aim of this study is to compare treatment and side effects of intraveneous (IV) diazepam, diphenhydramine and dimenhydrinate on patients with vertigo. Materials and Methods: Patients over 17 years of age who presented with vertigo as a chief complaint were included in the study. 2 mg diazepam, 50 mg diphenhydramine, or 50 mg dimenhydrinate were given IV over 2 min. Patients evaluated their vertigo perception with Likert numeric (1-10) scale during walking, standing, sitting, and supine positions. Patients also evaluated additional symptoms and side effects at the same times. Principal outcome measures were evaluated at 60 minutes. Results: 74 patients were entered into the study. All three medications were found equally effective to decrease vertigo symptoms. There was no statistical difference between groups for side effects, but at 60 minutes diphenhydramine and dimenhydrinate caused more sedation than diazepam (p=0.015). Mean level of change in sedation and drowsiness was significantly less in the diazepam group than others (p=0.025, p=0.033, respectively). Conclusion: Diazepam, diphenhydramine and dimenhydrinate are equally effective to treat vertigo in the emergency department. Diazepam has less sedation.