Table 1 – Types of vertigo (non-exhaustive list)[/caption]
Vomiting
In older people, dizziness significantly increases the risk of falls.7 Implementing appropriate interventions to address modifiable risk factors such as dizziness is of paramount importance. In cases of drug-induced dizziness, deprescribing can be considered if the medicine can be safely reduced, discontinued or substituted to prevent inappropriate prescribing cascades of potentially inappropriate medicines (PIM), especially in the context of older people.29
A national education program for pharmacists funded by the Australian Government under the Quality Use of Diagnostics, Therapeutics and Pathology program.[/caption]
The hypothalamus houses neurons that produce neuropeptides called orexin A and B, which were discovered in 1998, and represent one of the most exciting discoveries in sleep medicine.5,13–15 Orexin-producing neurons help us stay awake and alert, especially when we really need to focus, which is critical for survival.5,14 These neurons reach out to many brain areas that use other wakefulness messengers such as acetylcholine, dopamine, histamine, serotonin and noradrenaline. These areas ‘talk back’ to the hypothalamus, to further boost wakefulness signals.5 Similarly, the thalamus is an important region that also serves to relay wakefulness signals from the RAS.5
Another dual orexin receptor antagonist (DORA), vornorexant*, is under development and currently undergoing clinical trials.28 
Other medicines such as dimdazenil* (partial positive allosteric modulator at GABAA specific to alpha-1 and alpha-5 GABAA receptor subtypes)41 and zuranolone* (positive allosteric modulator for GABAA) have also been tested, with positive outcomes in trials. Zuranolone* is marketed overseas specifically for postnatal depression, but clinical trials for its use in insomnia are ongoing.40
Kristy Carter (she/her)
Louise Edwards (she/her) 
Protecting kids from medicine harm
References
PSA. Medicine safety: child and adolescent care report. 2025. At: www.psa.org.au/3d-flip-book/medicine-safety-child-and-adolescent-care-report/
Cairns R, Karanges EA, Wong A, et al. Trends in self-poisoning and...
Banishing bountiful B6
References
Australian Government Department of Health, Disability and Ageing. Therapeutic Goods Administration. Notice of interim decision to amend (or not amend) the current Poisons...
Keeping lifetime OCS below 1,000 mg
References
Price DB, Trudo F, Voorham J, et al. Averse outcomes from initiation of systemic corticosteroids for asthma: long-term observational study. J Asthma Allergy...
Managing pain and fever associated with childhood vaccination
References
Siegrist CA. Vaccine Immunology. In: Plotkin SA, et al, eds. Plotkin's Vaccines. 7th edn. Elsevier; 2018. p. 16–34.e7.
Australian Technical Advisory Group on...
