AAzad
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THIS IS A REAL CASE, PLEASE POST AN ANSWER.
THANKS
76y.o F.M.wlth IHD &MIx2 with 50% blockage of 4 coronaries and 80% of one coronary, is on amlodipine, Inderal ,AsA,Enalapril, and nitrocontin, and HCTZ she is also on Nortrilen . BP is 110/65 and PR is 65-70/min,she is very weak ang fatigue and has vertigo.ocasionally is depressed.
Can you find the reason/s of vertigo?
what is the best treatment?
Do you agree to replace nortrilen with SSri?
Thanks
Good luck
Edited by AAzad on 10/07/06 - 09:37 AM
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AAzad
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| AAzad
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any answer plz
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AAzad
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| ssrpk
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whtz ASA???
if thts aspirin, then aspirin can cause vertigo......which is reversible; simply reduce the dosage!
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| sarika
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nortriptyline is ass. with confusional states esp in elderly & (may also cause tinnitus) also Asa definitely contributes to vertigo.
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| robin082006
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Maybe Nortrilen
Aspirin is often used with very low dose in such patients (81 mg/day 0r 100 mg/day) so toxication is rare.
management: change to SSRI or other new depression agent with less side effects.
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| AAzad
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Thanks all
How about serteralin and olanzpin?
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AAzad
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| AAzad
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I just want to share with you and thank you all for your answers.
I D/C ed Nortrilen and started zoloft(12.5mg) Half a tab/day, and added olanzapine2.5 mg every night for the first week and then 5mg /at bed time.
In a 10 days period depression and Vertigo gone.
So I will consider depression as a contributoer to vertigo. What do you think?
GOOD LUCK.
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| Guptashutosh
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wel i `ve a diff view
1; there r two drugs which can give vertigo in this list ASA and Thiazide
2; enalapril can displace the alb bind drugs and increase the conc of thiazide
3; aspirin prophylaxis is given in small dose , will not cause vertigo even in long duration
4; decreasing thiazide dose might revert vertigo
any suggestions are welcome
GL
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