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Treating Motion Sickness

April 23, 2015

Motion sickness – Treatment

Introduction

For most people, motion sickness is just a minor annoyance (although it may not feel so minor at the time). The distressing symptoms of motion sickness usually stop when the motion that causes it ceases. Some travelers, however, can be incapacitated by motion sickness. There are people who suffer symptoms for even a few days after the trip is over. This is called the “mal d’embarquement” or “mal de debarquement” syndrome. (“Mal d’embarquement” is departure sickness while “mal de debarquement” is arrival sickness.)

Prevention

If you know you are prone to motion sickness or if you are suffering from it, the following is recommended:

  • Always ride where your eyes will see the same motion that your body and inner ears feel.
  • In a car, sit in the front seat and look at the distant scenery.
  • On a boat, go up on the deck and watch the motion of the horizon.
  • In an airplane, sit by the window and look outside, and/or choose a seat over the wings where the motion is minimized.
  • Do not read while traveling if you are subject to motion sickness, and do not sit in a seat facing backward.
  • Do not watch or talk to another traveler who is having motion sickness.
  • Avoid strong odors and spicy or greasy foods that do not agree with you (immediately before and during your travel).

Natural treatment

One common suggestion is to simply look out of the window of the moving vehicle and to gaze toward the horizon in the direction of travel. This helps to re-orient the inner sense of balance by providing a visual reaffirmation of motion.

In the night, or in a ship without windows, it is helpful to simply close one’s eyes, or if possible, take a nap. This resolves the input conflict between the eyes and the inner ear. Napping also helps prevent psychogenic effects, that is, the effect of sickness being magnified by thinking about it.

A simple method for relieving common and mild car sickness is chewing. Chewing gum has an uncanny effectiveness for reducing car sickness in those affected. Snacking on lollies or just chewing in general seems to reduce adverse effects of the conflict between vision and balance.

Fresh, cool air can also relieve motion sickness slightly, although it is likely this is related to avoiding foul odors which can worsen nausea.

Ginger root is commonly thought to be an effective anti-emetic. Ginger is reported to calm the pyloric valve located at the base of the stomach. This relaxation of the valve allows the stomach to operate normally whereby the contents will enter the small intestine instead of being retained within the stomach. It is this undesirable effect of retention in the stomach that eventually results in vomiting. Vomiting is not seasickness but is only a symptom or side effect; although the effect most commonly associated with seasickness. This link reports on a ginger study; notice the comment about less vomiting when taking ginger, but not less nausea.

Chemical treatment

Several medications are now available both by prescription and over the counter that may prevent or limit the symptoms of motion sickness.

Antihistamine medications are commonly used in the prevention and treatment of motion sickness. These medicines seem to prevent and treat the nausea, vomiting, and dizziness caused by motion sickness by calming the stimulation of the inner ear. Examples of antihistamines used for this purpose include meclizine (Bonine, Antivert, Dramamine).

Interestingly, many pharmacological treatments which are effective for nausea and vomiting in some medical conditions may not be effective for motion sickness. For example, metoclopramide and prochlorperazine, although widely used for nausea, are ineffective for motion-sickness prevention and treatment. This is due to the physiology of the CNS vomiting centre and its inputs from the chemoreceptor trigger zone versus the inner ear. Sedating anti-histamine medications such as promethazine work quite well for motion sickness, although they can cause significant drowsiness.

Over-the-counter and prescription medications are readily available, such as Dramamine (dimenhydrinate), Stugeron (cinnarizine), and Bonine/Antivert (meclizine). Stugeron (containing Cinnazirine) is not available in the U.S. It has been implicated in triggering palsy and has been banned by the FDA.

Another class of medications (belladonna) used to prevent motion sickness is represented by the scopolamine skin patch (Transderm Scop). The selection of a transdermal patch or scopolamine tablet is determined by a doctor after consideration of the patient’s age, weight, and length of time treatment is required.This medicated skin patch is applied behind the ear at least four hours in advance of the motion activity. The medication is slowly absorbed directly into the underlying skin.

When used specifically to prevent motion sickness, regardless of the type of medication, these medicines generally are most effective when administered well before embarking.

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