Motion sickness

Motion sickness is one of the most frequent medical problems encountered by travelers. It occurs less often in children, especially those less than two years of age, and more often in women, especially during pregnancy or menstruation. A variety of safe and effective medications are available. For shorter trips, the first-line drug is usually dimenhydrinate (Dramamine), an antihistamine that is available without a prescription in the United States and most other countries. The usual dosage is 50 or 100 mg every 4-6 hours as needed (maximum 400 mg in 24 hours). Meclizine is another antihistamine that is effective for motion sickness. In the United States, meclizine is available either in prescription strength (Antivert), given 12.5 or 25 mg up to three times daily, or in a lower-dose, over-the-counter formulation (Bonine) given 25 mg once daily. The most common side-effect of antihistamines is drowsiness. Less frequent problems include dry mouth, blurred vision, and thickened secretions. Antihistamines should be avoided in children under two years of age and those with narrow-angle glaucoma, prostatic hypertrophy, or pyloric or bladder neck obstruction.

The scopolamine patch (Transderm Scop), which is applied every three days to the skin behind the ear, is recommended for longer periods of motion (greater than 6 hours), such as cruises and other boat rides. The patch should be applied 4-8 hours before motion begins. Side-effects may include dry mouth, drowsiness, and blurred vision. Elderly individuals may experience confusion or hallucinations. The scopolamine patch should not be given to children, pregnant women, the elderly, or those with a history of glaucoma, liver or kidney disease, or urinary or pyloric obstruction. Sedatives should be avoided while wearing the patch. Severe motion sickness may be treated with promethazine (Phenergan), which is more likely than the abovementioned regimens to cause decreased alertness. The recommended dosage is 25-50 mg up to four times daily as needed.

Some people find that ginger, which is an herbal remedy, is extremely helpful in reducing motion sickness.

All oral medications should be given one hour before departure.

Other techniques for controlling motion sickness include

• choosing seats with the smoothest ride
• minimizing head and body movements
• fixing eyes on the horizon or another stable, distant object
• avoiding reading
• closing eyes
• performing mental activity
• avoiding alcohol and large meals
• lying supine, if necessary

From the Centers for Disease Control

Motion sickness