Dizziness: Exploring Autonomic Nervous System Disorders

Dizziness issues?

Doctor, I would like to ask if this condition is related to autonomic nervous system dysfunction.
On June 20, 2016, I woke up feeling dizzy, and then I experienced fainting spells, especially when turning my head, which made me feel particularly dizzy, accompanied by stiffness in the back of my neck.
It is not vertigo.
I later consulted an otolaryngologist, and my ears were found to be normal.
I also visited a neurologist, and my EEG was normal; the only tests I haven't done are a CT and MRI of the brain and cervical spine.
I went to an orthopedic doctor for my neck pain, and X-rays showed no issues.
Should I consider going to a family medicine doctor for a CT and MRI of my brain and cervical spine?
For the past three months, I have been taking Eurodin, which was effective for the first 1-2 weeks, making me feel less dizzy and improving my mood.
However, I have since returned to feeling anxious and dizzy.
Is this due to the development of tolerance to benzodiazepines (BZD)? The doctor has also prescribed Fludiazepam 0.25 mg (Eisuh tablets, Fuanyuan tablets) and bromazepam (Mu Jing tablets).
I found online that these two are also BZD medications; do they also have a high potential for tolerance, or can I continue taking them if I still feel unwell? I still take one Eurodin tablet every night before bed.
Additionally, I was prescribed Bupropion Hydrochloride (Wellbutrin) 150 mg for persistent effects, but I still feel dizzy during the day.
The doctor then switched me to taking 2 tablets of Sepirone (Ibilong) before bed.
Can this medication be taken during the day, or will it also cause dizziness? Will taking it for two weeks gradually improve my mood? I am also concerned about the potential sexual side effects of SSRIs and SNRIs.
Whenever I feel dizzy, I tend to become anxious and nervous.
Can I combine Propranolol 10 mg (Inderal) and Flunarizine 5 mg (Sibelium) with my current medications? Should these medications be taken during the day for better effect, or is it better to take them at night? I am worried that these medications might also cause dizziness.
Thank you, Dr.
Zhong, for taking the time to read my message.

Mr. Li, 20~29 year old female. Ask Date: 2016/09/17

Dr. Zhong Mingxun reply Psychiatry

Indeed, anxiety and emotional distress can lead to dizziness; however, medication can only help alleviate your symptoms and cannot cure the underlying issues.
I recommend that you seek a physician who specializes in psychotherapy to thoroughly discuss the sources of your stress.
Long-term improvement may require addressing your internal personality and emotional issues.
Regarding medication, I suggest you have a detailed discussion with the prescribing physician, as it is not appropriate for me to directly advise you on medication usage.

Reply Date: 2016/09/17

More Info

Dizziness and related symptoms can often be attributed to a variety of underlying conditions, including disorders of the autonomic nervous system (ANS). The ANS regulates involuntary bodily functions, including heart rate, blood pressure, and digestion. When this system is disrupted, it can lead to symptoms such as dizziness, lightheadedness, and even fainting. Your description of experiencing dizziness upon waking, along with neck pain and the sensation of spinning, suggests that you may be dealing with an autonomic dysfunction or another related issue.

Given that you have already undergone several evaluations, including ear, nose, and throat (ENT) assessments and neurological examinations (such as EEG), it is essential to consider further imaging studies like CT or MRI of the brain and cervical spine. These tests can help rule out structural abnormalities that might be contributing to your symptoms. For instance, conditions such as cervical spondylosis or disc herniation can lead to neck pain and dizziness due to nerve compression or vascular compromise.

The medications you mentioned, including Eurodin (a benzodiazepine), Fludiazepam, and Bromazepam, are indeed benzodiazepines, which can lead to tolerance and dependence if used long-term. Tolerance means that over time, you may require higher doses to achieve the same effect, which could explain why you feel that the initial benefits of Eurodin have diminished. It is crucial to discuss any concerns about medication efficacy and side effects with your healthcare provider, as they can help adjust your treatment plan accordingly.

Regarding the use of Bupropion, which is an atypical antidepressant, it is generally considered to have a lower risk of sexual side effects compared to SSRIs and SNRIs. However, it can still cause dizziness, especially when starting the medication or adjusting the dose. Sepirone (Buspirone) is an anxiolytic that can be used for anxiety and may help improve mood over time, but it typically takes a few weeks to notice significant effects.

Propranolol, a beta-blocker, is often used to manage anxiety symptoms and can help with physical symptoms such as palpitations and tremors. Flunarizine is a calcium channel blocker that can be effective in treating migraines and vestibular disorders, but it may also cause sedation or dizziness. The timing of these medications can be important; for example, taking sedating medications at night may help minimize daytime drowsiness.

It is essential to communicate openly with your physician about your symptoms, concerns regarding medication side effects, and the impact of dizziness on your daily life. They can help you navigate the complexities of your treatment plan and may consider referring you to a specialist in autonomic disorders or a neurologist with expertise in dizziness and balance issues.

In summary, your symptoms could indeed be related to autonomic nervous system dysfunction, but further evaluation through imaging studies is warranted to rule out other potential causes. Managing your medications carefully and maintaining open communication with your healthcare provider will be crucial in finding an effective treatment strategy. If you continue to experience significant dizziness or other concerning symptoms, do not hesitate to seek further medical attention.

Similar Q&A

Understanding Autonomic Nervous System Disorders: Symptoms and Connections

Hello doctor, two years ago, I suddenly felt a wave of dizziness one day, as if I were about to faint, but I never actually lost consciousness. Since that day, I have felt like I am constantly swaying, as if I were on a boat, whenever I am awake, although it doesn’t feel like the...

Dr. Cai Zongzhang reply Neurology
Hello, it is recommended that you maintain a regular sleep schedule and a balanced diet, identify sources of stress in your life, and practice stress-relief techniques. This should help improve your condition. If the issues persist, it is advisable to have regular follow-up appoi...

Understanding Dizziness and Palpitations: A Neurological Perspective

Hello Doctor, I have been experiencing dizziness, disorientation, palpitations, and discomfort in certain situations (perhaps when there are many people around) for a long time, which has been quite distressing and affects my mood. I do not understand the underlying cause, as my ...

Dr. Ye Boshou reply Neurology
Stress and tension can lead to the aforementioned conditions. Engaging in more physical activity and relaxing your mind can help improve the situation. Wishing you all the best.

Understanding Autonomic Nervous System Issues: Symptoms and Solutions

Hello Doctor: For the past four months, I have been feeling dizzy. My usual blood pressure readings are around 100 to 120. I have fainted before while donating blood, and sometimes I experience tinnitus. Recently, I have been feeling fatigued easily, and my hands tremble when I a...

Dr. Liang Sunyuan reply Psychiatry
Hello: There are many possible reasons, including anemia, autonomic nervous system issues, vertigo, or other factors. It is recommended that you seek medical attention for a more detailed evaluation. Wishing you all the best.

Understanding Persistent Dizziness: Causes and Anxiety Connections

Hello, doctor. I do not have anemia, and my thyroid function is normal, but I have been experiencing dizziness. This occurs whether I am lying down, squatting, sitting, or standing (walking). It is not a sensation of vertigo, nor do I feel unsteady or at risk of falling; it'...

Dr. Jiang Junyi reply Neurology
Dear Miss Enola, You mentioned that "besides lying down... symptoms occur when squatting, sitting, and standing (walking)." Your symptoms may suggest insufficient cerebral blood flow leading to dizziness. It may also be worth considering the possibility of sympathetic ...