Motion sickness is experienced by many individuals and is associated with nausea, vomiting, hyperventilation, and headaches. Although it is most commonly experienced during travel, such as on a car, boat, or plane, motion is not necessarily required for symptoms to occur. Certain situations where a person is looking at a screen can also result in motion sickness even if the body is not moving. The most common explanation for motion sickness is that it occurs when there is a mismatch between how the body perceives it is moving and how it is actually moving. For many people the condition can be disabling – especially for those whose work requires them to frequently experience situations likely to cause motion sickness.
Who Gets Motion Sickness?
Anyone can get motion sickness and you may be more or less susceptible at different times. Certain medications may increase your susceptibility to getting motion sickness. Women are more likely than men to get motion sickness, and it is also common in young children over the age of 2. It most commonly occurs during travel and can go by different names like car sickness and sea sickness but is related to the same mechanism. Individuals who work on ships or planes or drive frequently may have more opportunities to have motion sickness. Much research has been done into treating seasickness in particular as often trips can be for an extended periods of time without the opportunity to “pull over.”
Treatments for Motion Sickness
The treatments for motion sickness include both pharmacological interventions and complementary medical therapies. The most commonly prescribed medication is scopolamine. Medications besides scopolamine may include other anticholinergics, antihistamines, sympathomimetics, and opioids. Other therapies include visualization, biofeedback, acupressure, acupuncture, and herbal remedies like ginger. Medications are most often effective when combined with behavioral strategies. For example, people who get motion sickness in the car often report that looking at the horizon helps reduce the chances they will become sick. These types of behavioral strategies can be useful but may not always work. Medications may be able to provide more assurance if they work for the individual.
What is Scopolamine?
Scopolamine is a naturally occurring substance derived from solanaceous plants (the nightshade family), in particular henbane. It was first documented in 1881 but the plants it is derived from had likely been used medicinally for many centuries before then. It works to treat motion sickness by interfering with the transmission of vestibular input to the central nervous system. Various forms of the drug can be used including patches, tablets, injectable, and oral liquid formulations. Currently only the patch form is commercially available from retail pharmacies. Scopolamine capsules can still be made by a compounding pharmacy with a prescription. While the patches may last a few days, the oral forms of the drug need to be taken more frequently. Scopolamine has been used to treat motion sickness as well as post-operative nausea, irritable bowel syndrome, gastrointestinal spasms, and other conditions.
Research on Scopolamine for Motion Sickness
A meta-analysis of various forms of scopolamine used for managing motion sickness showed that it is more effective than placebo at preventing nausea and vomiting. Common adverse effects include drowsiness, dry mouth, dizziness, and visual disturbances. These side effects are typical of anticholinergic medications.
A double-blind, randomized, crossover study of 76 naval crew members compared scopolamine with cinnarizine (an antihistamine) in the prevention of seasickness. A higher efficacy, less adverse reactions, and convenience all led the naval crew member participants of this study to prefer the scopolamine to cinnarizine. The researchers concluded that, “it is recommended that the scopolamine patch be used as the drug of choice for the treatment of seasickness among naval crew in particular and probably also among all other sea travelers.” Read Article: A comparison of cinnarizine and transdermal scopolamine for the prevention of seasickness in naval crew: a double-blind, randomized, crossover study (opens in new window).
A combination of transdermal and oral use of scopolamine has been frequently studied. This is because the transdermal patch does not start working immediately. After application, the patch takes a minimum of 6 hours and up to 12 hours to start working. In contrast, the oral form of the drug takes effect almost immediately – within a half hour of administration. The studies that combine both forms utilize the immediate oral form to manage motion sickness during the first 12 hours of a journey (often by sea) so the patch has time to start working. Read Article: Scopolamine Bioavailability in Combined Oral and Transdermal Delivery (opens in new window).
The effect of scopolamine on the physiological patterns of motion sickness has also been examined. According to researchers, “the scopolamine group reported fewer motion sickness symptoms, and displayed lower HR, higher vagal tone, enhanced normal gastric myoelectric activity, and depressed gastric dysrhythmias before and during motion sickness induction.” Scopolamine protects against motion sickness by initiating a pattern of increased vagal tone and gastric myoelectric stability. Vagal tone is the activity of the vagus nerve which regulates various parts of the body when at rest. Gastric instability (dysrhythmias) are associated with nausea. Read Article: Effects of scopolamine on autonomic profiles underlying motion sickness susceptibility (opens in new window).
Compounded Scopolamine Capsules
Currently, the only type of scopolamine formulation that is available in manufactured form is the scopolamine patch. There are no oral formulations like tablets or capsules. However a compounding pharmacy can use pharmaceutical ingredients to compound drugs in many different forms. Park Compounding Pharmacy compounds scopolamine in capsules for oral use. Many patients prefer this method of administration because it is much faster acting than the transdermal patch. In many cases, patients need relief from motion sickness much more spontaneously and can not plan to apply a patch 12 hours prior to taking a trip or engaging in an activity that may cause motion sickness.