Preventing and treating seasickness
It Can Happen to Anyone…
• Anyone can get seasick. It won’t kill you, but for a while you
• If you’ve had motion sickness before, plan ahead and take
an OTC drug before embarking. Or get a prescription for
The English words “nautical” and “nausea” derive
brain incorrectly interprets the distress caused by
scopolamine or another powerful antiemetic (antinausea) drug.
from the same Greek root naus
= ship, and for good
this motion as the result of poisoning, and causes
• Use an alternative remedy, if you think it will work.
reason. People have been getting seasick for
stomach disturbance leading to vomiting.
• If you take a drug you have not had before, “test drive” it
ahead of time for eﬀectiveness and side eﬀects.
While seasickness is miserable and can be
tress (dizziness and nausea) experienced by
P r e v e n t i n g
On the boat, position yourself to minimize the eﬀects of
debilitating, it can be prevented and even
the brain, and the stomach’s reaction to it.
You can have one without the other. Folk
• If you start to get sick, be considerate of others. If a
companion gets sick, protect him/her from injury or falling
not stop the nausea’s root cause, which
• If seasickness strikes, try the chew-but-don’t-swallow
information from those studies is presented in this
References for Further Reading
from a conﬂict between what the inner ear detects
Gahlinger, P.M., M.D. Ph.D. 1999. How to help your patients avoid travel travail. Postgraduate Medicine
and what the eyes see. If this were the whole prob-
Jacobs, M.E., M.D. 2001. Survival at sea: Seasickness. In: P.S. Auerbach (ed.), Wilderness medicine, 4th
What Is Seasickness?
lem, it could be prevented or cured by keeping an
edn. Harcourt Health Sciences Company, pp. 1530-1531.
Money, K.E., J.R. Lackner, and R.S. Cheung. 1996. The autonomic nervous system and motion sickness.
eye on the horizon outside the boat. This works for
In: B.J. Yates and A.D. Miller (eds.), Vestibular autonomic regulation. CRC Press, pp. 147-173.
Seasickness is an unpleasant condition that may
Onan, C. 1991. In search of a cure for seasickness. Cruising World, December.
some people, but not for the majority.
Scavone, J.M., B.G. Luna, J.S. Harmatz, L. von Moltke, and D.J. Greenblatt. 1990. Diphenhydramine
include dizziness, tiredness, acid stomach, and
kinetics following intravenous, oral, and sublingual dimenhydrinate administration. Biopharmaceutics and Drug Disposition 11(3):185-189. (Abstract accessible at http://www.ncbi.
nausea/vomiting. It usually comes from rhythmic
How to Predict Seasickness
Weinstein, S.E., and R.M. Stern. 1997. Comparison of Marezine and Dramamine in preventing
motion of sea waves. People rarely get seasick from
symptoms of motion sickness. Aviation, Space, and Environmental Medicine 68(10):890-894.
Wood, C.D., Ph.D., and A. Graybiel, M.D. 1968. Evaluation of sixteen anti-motion sickness drugs under
bouncing as a small boat skips over the sea—it’s the
Seasickness can strike anyone, including seasoned
controlled laboratory conditions. Aerospace Medicine 39:1341-1344.
slower motion of natural waves that does it.
professional mariners. Most people get over it in a
Written by Terry Johnson, Marine Advisory Agent, University of Alaska Fairbanks, Homer, Alaska
99603. NOAA National Sea Grant NA16RG2321, projects A/161-01 and A/152-20. UAF is an AA/EO
Seasickness occurs when the visual, vestibular
few days if they are at sea that long, but knowing
(inner ear), and proprioceptor
(receptors in the
this is little comfort if your ﬁshing trip is spoiled.
muscle and joints that signal locomotion and pos-
Try reading, while riding as a car passenger in stop-
ture) systems are in conﬂict with each other or not
and-go traﬃc or on winding roads. If you get carsick
consistent with past experience. The subconscious
in this test, there’s a good chance you’l get seasick.
dimenhydrinate or meclizine tablets. If you ﬁnd that you’re starting to feel sick, take a couple of the tablets and chew but
To Prevent Seasickness
don’t swallow. Instead, hold the “mush” under your tongue
or Ease Symptoms
Most over-the-counter (OTC) drugs for prevention of motion
or against the inside of your cheek, where the drug can be
sickness are based on antihistamines. They work by depressing
absorbed through the lining of the mouth. Research shows that
The night before:
the brain’s emetic or vomiting center. They are moderately
the drug passes into the bloodstream, although it still takes a
eﬀective and have minimal side eﬀects, including drowsiness
couple of hours to reach full strength. Some suﬀerers report
excellent results from this approach.
• Take an advance dose of medicine (see “OTC Drugs” section).
Drugs based on meclizine (Bonine, Antivert, Dramamine II)
cause less drowsiness than the old standard drug,
The morning of the voyage:
dimenhydrinate (original Dramamine, Triptone, Gravol).
Common Medications for
• Eat only a light breakfast, avoiding rich or fatty foods.
Diphenhydramine (Benadryl), an antihistamine also used as a
Alternative, Folk, and
sleeping pill, can cause signiﬁcant drowsiness.
Over the countera
Many people don’t want to use drugs to prevent or cure
Using OTC Drugs Effectively
On the boat:
seasickness, so they use alternatives. Most of these alternatives
have not proven eﬀective in clinical trials, but some users report
Most dimenhydrinate- and meclizine-based drugs are sold as
• Take a position with a good outside view, low and near the
pills or as chewable tablets. They should be taken at least two
hours before boarding so the drug can go through the digestive
Avoid smells of exhaust, fuel, the galley, and the head (toilet).
, as powdered or candied root, cookies, tea, or ginger
ale, soothes the stomach of many suﬀerers.
system and into the bloodstream. A person already nauseous
• Avoid reading or work requiring close-up focus (like
on the nei kuan
or precordial #6 position
or vomiting will get no beneﬁt because the
drug will be expelled in the next bout of
on the inside of the wrist, prevents nausea in many people.
vomiting, or will be trapped in the stressed
Elastic wristbands with plastic beads that press on the wrist
• An electronic device that resembles a wristwatch and sends
If you start feeling sick:
a mild, user-variable, electric current into the wrist (at the nei
• Acknowledge the situation and tell the captain or crew.
position) can prevent seasickness or stop it after it has
• Avoid going below or into enclosed spaces
There’s no harm in trying alternative remedies, and they may
If you think you’re going to throw up:
be all you need. But most seasick-prone people need drugs to
• Vomit over the side, on the downwind side, or in the head.
others cut it in half. Further, some OTCs lose eﬀectiveness in 4-6
hours. You might want to “test drive” a drug ahead of time (well
• Many people feel much better after vomiting.
before you go boating) for eﬀectiveness and side eﬀects.
A second component of drug eﬀectiveness is faith in the
If your companions are seasick:
drug. Studies show that as much as 40% of all seasickness can
The transdermal scopolamine patch, sold by prescription, is very
be alleviated by the belief that the drug is eﬀective, even if the
• Protect them from injury or falling overboard.
popular among recreational boaters and professional mariners. For
patient has taken a sugar pill (placebo) instead of the real thing.
Prescription drug combinations
• Encourage them to drink water or sport
most people the side eﬀects are minimal, the patch is convenient,
Scopolamine + dextroamphetaminef
and it lasts up to three days. Scopolamine works wel for most
Promethazine + ephedrine or
people, but should be used only under a doctor’s supervision.
Here’s Something to Try
especially susceptible to dehydration.
Most other prescription drugs for seasickness are used
Too often people don’t think they will get seasick until they get
only by the severely aﬀected. They are taken as a pill, injection,
c Antivert is a prescription f Dexedrine is
suppository, syrup, or salve. Some are quite potent, and side
out on the water, and then it’s too late to take an OTC drug as
a preventative. If you’re one of those, here’s something you can
eﬀects can be serious or even life-threatening.
Gravol is not available in less drowsiness.
try. Next time you go out, take along a package of chewable
Reprinted from Issue 2 • 2004 Editorial Domperidone Warning: Important or Importation? Here you have it! The perfect example of how profits and politics influence health care. The recent statements from the Food and Drug Administration (FDA) about domperidone are so obviously motivated by politics and profits that the potential impact on health takes a back seat. (See relate
BACKGROUND UK and international guidelines suggest the management of hayfever should start with allergen avoidance and if that fails, treatment with an antihistamine. Where these treatments are ineffective, regular intranasal corticosteroids should be used. Intranasal steroids are more effective if used at the start of the season and in the presence of established nasal congestion, a topical