Least sedating benzodiazepine
All anticholinergics used in the management of vertigo have prominent side effects of dry mouth, dilated pupils, and sedation.
Withdrawal has been described from a similar agent to meclizine, diphenhydramine. With the possible exception of astemizole (Hismanal) in Meniere's disease (Turner and Jackson, 1989), antihistamines that do not cross the blood brain barrier, are not used to control vertigo.
Unfortunately, astemizole does not appear to be generally useful as it is ineffective in preventing motion sickness (Kohl et al, 1987) and because it has significant potential toxicity.
There are also some reports of scopolamine inducing migraine, as well as a withdrawall syndrome.
There is no reason to believe that any one nonselective ACH antagonist (e.g.
The atrophine derivitive, hyocyamine (L-atropine), can be used instead.