Feeling unsteady, dizzy, or off-balance isn’t always a sign of aging or an inner ear problem. In many cases, medications are a hidden but common cause of balance issues, especially when starting a new prescription, changing doses, or combining multiple drugs.
Below are 10 types of medications known to affect balance, why they do it, and what to watch for.
Important: Never stop or change a medication without speaking to your healthcare provider.
1. Benzodiazepines (Anti-Anxiety & Sedatives)
Examples: Alprazolam (Xanax), Diazepam (Valium), Lorazepam (Ativan)
These drugs slow the central nervous system, which can impair coordination, reaction time, and muscle control—leading to unsteadiness or falls.
Risk increases with: Older age, higher doses, long-term use
2. Sleep Medications
Examples: Zolpidem (Ambien), Eszopiclone (Lunesta)
Sleep aids can cause lingering sedation, confusion, and poor coordination—especially during nighttime awakenings.
3. Antidepressants
Examples: SSRIs (sertraline, fluoxetine), TCAs (amitriptyline)
Some antidepressants affect blood pressure, alertness, and reflexes, increasing dizziness or balance problems, particularly when starting treatment.
4. Blood Pressure Medications
Examples: Beta-blockers, ACE inhibitors, diuretics
These can cause orthostatic hypotension—a sudden drop in blood pressure when standing—leading to lightheadedness or falls.
5. Pain Medications (Opioids)
Examples: Oxycodone, Hydrocodone, Morphine
Opioids depress the nervous system and can cause dizziness, slowed reactions, and impaired balance.
6. Antihistamines (Especially First-Generation)
Examples: Diphenhydramine (Benadryl)
Older antihistamines cross into the brain and often cause drowsiness, blurred vision, and poor coordination.
7. Anti-Seizure Medications
Examples: Phenytoin, Carbamazepine, Valproate
These drugs affect nerve signaling and commonly cause dizziness, ataxia (loss of coordination), and balance issues.
8. Muscle Relaxants
Examples: Cyclobenzaprine, Baclofen
By relaxing muscles and depressing the nervous system, these medications can interfere with posture and coordination.
9. Antipsychotic Medications
Examples: Quetiapine, Risperidone, Haloperidol
These drugs may affect motor control, reflexes, and blood pressure regulation, contributing to instability.
10. Medications for Parkinson’s Disease
Examples: Levodopa/carbidopa
While essential for symptom control, these medications can cause dizziness and postural instability, especially during dose adjustments.
Who Is Most at Risk?
- Adults over 60
- People taking multiple medications
- Those with inner ear disorders or neurological conditions
- Individuals who recently changed dosages
What You Should Do If You Feel Off-Balance
- Report symptoms promptly to your doctor or pharmacist
- Ask if timing, dose adjustments, or alternatives are possible
- Avoid alcohol while on balance-affecting medications
- Rise slowly from sitting or lying positions
- Use handrails and proper footwear
The Bottom Line
Loss of balance is a serious side effect—not just an inconvenience. Medications that affect the brain, nerves, muscles, or blood pressure can all play a role, and the risk increases when drugs are combined.
If you’ve noticed dizziness, unsteadiness, or recent falls, your medication list may be the first place to look. A simple review with a healthcare professional can sometimes make a life-changing difference.
If you’d like, I can also:
- Create a printable checklist
- Break this down by age group
- Or explain which combinations are most risky
