Discussions that mention phenytoin

Inner Ear Disorders board

I found this on Dr. Hain's website:

Treatment for Mal de Debarquement
After the MDD has started, most medications that work for other forms of dizziness or motion sickness are ineffective. Specifically, antivert, bonine, meclizine, dramamine, scopolamine seem to be of little use. Valium and related medications such as Klonapin are helpful in some persons. There is some worry that these medications may prolong the duration of symptoms (although this worry has not yet been tested by a research study). An antidepressant called amitriptyline may also be helpful. Occasionally persons with rocking due to other causes respond to one of the SSRI type antidepressants, and this may also be worth considering. Hormonal medications such as estrogen or progesterone might be problematic -- it might be worth a trial of stopping them if this is practical. Recently (11/2001) we have been told that non-steroidal anti-inflammatory medications such as "Celebrex" or "Vioxx" have helped two patients. Also anecdotally, phenytoin and carbamazepine (or oxy-carbamazepine) may be useful in reducing symptoms. A controlled trial of these medications may be in order if more evidence accumulates.

Prevention: It is possible that medications taken prior and during boat travel might prevent development of MDD. Anecdotal evidence suggests that while antivert and scopolamine are ineffective, some people can prevent MDD by taking Valium, Klonapin, or Ativan prior to getting on the boat or airplane. Again, this possibility has not been tested by a research study and a trial, perhaps controlled with one of the medications known not to prevent MDD might be helpful. Nevertheless, medications which suppress the inner ear or block adaptation to inner ear signals might be useful.

Physical therapy: Physical therapy may be helpful in MDD, although the evidence is not very strong. In our study, 10/15 persons who had vestibular rehabilitation reported improvement, but the natural history of MDD is to improve, and one wonders what would have happened had they not undergone rehabilitation. Zimbelman (see below) has written a review of rehabilitation in MDD. A controlled trial of vestibular rehabilitation in MDD would be helpful.

Avoidance of motion is clearly helpful. If you get dizzy from riding on boats, don't do it !