Polypharmacy in the vestibular clinic
Reviewed by Clair Saxby

Polypharmacy is defined as the simultaneous use of five or more medications and its prevalence is increasing. Dizziness or vertigo are common side effects of polypharmacy. Despite advancements in patient data management, there remains limited information on polypharmacy in patients referred to vestibular clinics. The study looked to quantify the prevalence of polypharmacy in patients with dizziness in a tertiary multidisciplinary vestibular clinic and the association with patient-reported outcome measures. Out of the 382 included patients, 69.4% met criteria for polypharmacy, of which 94.0% were prescribed a potentially ototoxic drug. Polypharmacy is more common when light-headedness is one of the dizziness descriptors and seems to be associated with worse scores on patient-reported outcome measures (dizziness handicap index). Medication reconciliation and multidisciplinary involvement could help to address polypharmacy in patients presenting to vestibular clinics. We should view deprescribing as a clinical intervention where medications in a patient’s profile are reviewed and stopped if deemed to be clinically inappropriate or the cause of adverse effects. This has multiple benefits, including reduction of medication burden, cost, adverse effects, and potential drug-drug interactions.

Prevalence of Polypharmacy in Patients with Vestibular and Balance Complaints.
Jeong S, Chen T, Timor T, et al.
EAR HEAR
2023;44(3):506-17.