Pharmacological Treatment of Motion Sickness

  • Thomas G. DobieEmail author
Part of the Springer Series on Naval Architecture, Marine Engineering, Shipbuilding and Shipping book series (NAMESS, volume 6)


Practically everything has been tried at one time or another to treat motion sickness. There are a number of medications that are quite effective, although most have some unwanted side effects and some adversely affect performance. Scopolamine and promethazine are still considered to be the most effective anti-motion sickness medications. Perhaps the most disturbing feature of the anti-motion sickness drug story is that nothing new and effective has appeared in the last forty years or so. Recently, drugs that have effective anti-emetic properties in certain clinical settings have not been found to be effective in a motion environment. If you are treating passengers, make your choice of medication according to circumstances such as duration and severity of exposure and individual idiosyncrasies. When dealing with operators of potentially hazardous equipment or those performing certain skilled tasks, the choice is more difficult and it may be better to avoid drugs all together.


  1. Attias J, Gordon C, Ribak J, Binah O, Rolnick A (1987) Efficacy of transdermal scopolamine against seasickness: a 3-day study at sea. Aviat Space Environ Med 58:60–62Google Scholar
  2. Brand JJ (1970) A survey of recent motion sickness research. J R Nav Med Serv 56:204–207Google Scholar
  3. Brand JJ, Perry WLM (1966) Drugs used in motion sickness. A critical review of the methods available for the study of drugs of potential value in its treatment and of the information which has been derived by these methods. Pharmacol Rev 18(1):895–924Google Scholar
  4. Brand JJ, Colquhoun WF, Gould AF, Perry WLM (1965) A study of the relative potencies of l-hyoscine and cyclizine in preventing motion sickness, in preventing side effects, and in affecting mental performance. R.N.P. 66/1068, S.S. 155. Medical Research Council, Royal Naval Personnel Research CommitteeGoogle Scholar
  5. Brazell C, Preston GC, Ward C, Lines CR, Traub M (1989) The scopolamine model of dementia: chronic transdermal administration. J Psychopharmacol 3:76–82CrossRefGoogle Scholar
  6. Brodman K, Erdman AJ Jr, Wolff HG (1949) Cornell medical index health questionnaire—manual. Cornell University Medical College, New YorkGoogle Scholar
  7. Chelen W, Kabrisky M, Hatsell C, Morales R, Fix E, Scott M (1990) Use of phenytoin in the prevention of motion sickness. Aviat Space Environ Med 61:1022–1025Google Scholar
  8. Cheung BSK, Money KE, Kohl RL, Kinter LB (1992) Investigation of anti-motion sickness drugs in the squirrel monkey. J Clin Pharmacol 32(2):163–175CrossRefGoogle Scholar
  9. Chinn HI, Smith PK (1953) Motion sickness. Pharmacol Rev 7:33Google Scholar
  10. Cowings PS, Toscano WB, DeRoshia C, Miller NE (2000) Promethazine as a motion sickness treatment: impact of human performance and mood states. Aviat Space Environ Med 71:1013–1022Google Scholar
  11. Doweck I, Gordon CR, Spitzer O, Melamed Y, Shupak A (1994) Effect of cinnarizine in the prevention of seasickness. Aviat Space Environ Med 65:606–609Google Scholar
  12. Estrada A, Le Duc PA, Curry IP, Phelps SE, Fuller DR (2007) Airsickness prevention in helicopter passengers. Aerosp Med Assoc 78(4):408–413Google Scholar
  13. Evans MA, Martz R, Rodda BE, Kilplinger GF, Forney RB (1973) Quantitative relationship between blood alcohol concentration and psychomotor performance. Clin Pharmacol Ther 15:253–260CrossRefGoogle Scholar
  14. Fleishman E, Quaintance M (1984) Taxonomics of human performance. Wiley, New YorkGoogle Scholar
  15. Glaser EM, Hervey GR (1952) Further experiments on the prevention of motion sickness. Lancet 490–492CrossRefGoogle Scholar
  16. Golding JF, Strong R, Pethybridge R (1988) Time course of oral Cinnarizine effects on task performance. INM REPORT 18/88, Institute of Naval Medicine, Gosport, Hants, UKGoogle Scholar
  17. Golding JF, Gosden E, Gerrell J (1991) Scopolamine blood levels following buccal versus ingested tablets. Aviat Space Environ Med 62:521–526Google Scholar
  18. Gordon C, Binah O, Attias J, Rolnick A (1986) Transdermal scopolamine: human performance and side effects. Aviat Space Environ Med 57:236–240Google Scholar
  19. Graybiel A, Knepton J (1977) Evaluation of a new antinauseant drug for the prevention of motion sickness. Aviat Space Environ Med 48:867–871Google Scholar
  20. Graybiel A, Lackner JR (1987) Treatment of severe motion sickness with antimotion sickness drug injections. Aviat Space Environ Med 58:773–776Google Scholar
  21. Graybiel A, Miller EF, Homick JL (1977) Human vestibular function. In: Johnston RS, Dietlein LF (eds) Biomedical results from SkyLab. NASA SP-377, National Aeronautics and Space Administration, Washington, D.C.Google Scholar
  22. Hardman JG, Limbird LE, Molinoff PB, Ruddon RW (eds) (1996) Goodman and Gilman’s the pharmacological basis of therapeutics, 9th edn. McGraw-Hill, New YorkGoogle Scholar
  23. Holling HE, McArdle B, Trotter WR (1944) Prevention of seasickness by drugs. Lancet I:127–129CrossRefGoogle Scholar
  24. Jennings RT, Beck BG, Davis JR, Bagian JP (1993) Treatment efficacy of IM promethazine for space motion sickness in first flight shuttle crewmembers. Aviat Space Environ Med 64:423 (Abstract #27)Google Scholar
  25. Kennedy RS, Odenheimer RC, Baltzley DR, Dunlap WP, Wood CD (1990c) Differential effects of scopolamine and amphetamine on microcomputer-based performance tests. Aviation, Space, and Environmental Medicine 61: 615–621Google Scholar
  26. Kennedy RS, Wood CD, Graybiel A, McDonough RB (1966) Side effects of some anti-motion sickness drugs as measured by psychomotor test and questionnaires. Aerosp Med 37:408–411Google Scholar
  27. Kohl RL (1987) Failure of metoclopramide to control emesis or nausea due to stressful angular or linear acceleration. Aviat Space Environ Med 58:125–131Google Scholar
  28. Kohl RL, Calkins DS, Mandell AJ (1986) Arousal and stability: the effects of five new sympathomimetic drugs suggest a new principle for the prevention of space motion sickness. Aviat Space Environ Med 57:137–143Google Scholar
  29. Lawther A, Griffin MJ (1988) A survey of the occurrence of motion sickness amongst passengers at sea. Aviat Space Environ Med 59:399–406Google Scholar
  30. Lee JA, Watson LA, Boothby G (1986) Calcium antagonists in the prevention of motion sickness. Aviat Space Environ Med 57:45Google Scholar
  31. Lucot JB (1998) Pharmacology of motion sickness. J Vestib Res 8(1):61–66CrossRefGoogle Scholar
  32. Marley JE, Joy MD (1987) Alleviation of motion sickness by nifedipine. Lancet 2:1265CrossRefGoogle Scholar
  33. Matsnev EI, Bodo D (1984) Experimental assessment of selected antimotion drugs. Aviat Space Environ Med 55(4):281–286Google Scholar
  34. Miller EF, Graybiel A (1970a) A provocative test for grading susceptibility to motion sickness yielding a single numerical score. Acta Otolaryngol 5(274)Google Scholar
  35. Miller EF, Graybiel A (1970b) Motion sickness produced by head movement as a function of rotational velocity. Aerosp Med 41:1180–1184Google Scholar
  36. Nieuwenhuijsen JH (1958) Experimental investigations on seasickness. Ph.D. thesis, University of Utrecht, The NetherlandsGoogle Scholar
  37. Norfleet WT, Degioanni JJ, Calkins DS, Reschke MF, Bungo MW, Kutyna FA, Homick JL (1992) Treatment of motion sickness in parabolic flight with buccal scopolamine. Aviat Space Environ Med 63:46–51Google Scholar
  38. Noy S, Shapiro S, Zilbiger A, Ribak J (1984) Transdermal therapeutic system scopolamine (TTSS), dimenhydrinate, and placebo—a comparative study at sea. Aviat Space Environ Med 55:1051–1054Google Scholar
  39. Oosterveld WJ (1974) Vestibular pharmacology of flunarizine compared to that of cinnarizine. Oto-Rhino-Laryngologica 36:157–164Google Scholar
  40. Oosterveld WJ (1991) Assessment of drug effectiveness. In: Motion sickness: significance in aerospace operations and prophylaxis. Conference proceedings no 175, AGARD-LS-175, North Atlantic Treaty Organization Advisory Group for Aerospace Research and Development, Neuilly-sur-Seine, France, vol 10, pp 1–8Google Scholar
  41. Oosterveld WJ, Graybiel A, Cramer DB (1972) Influence of vision on susceptibility to acute motion sickness studied under quantifiable stimulus-response conditions. Aerosp Med 43(9):1005–1007Google Scholar
  42. Parrott AC (1989) Transdermal scopolamine: a review of its effect upon motion sickness, psychological performance, and physiological functioning. Aviat Space Environ Med 60:1–9Google Scholar
  43. Paul MA, MacLellan M, Gray G (2005) Motion sickness medications for aircrew: impact on psychomotor performance. Aviat Space Environ Med 76:560–565Google Scholar
  44. Payne RB, Moore EW, Bethurum JL (1952) The effects of certain motion sickness preventatives upon psychological efficiency. USAF School of Aviation Medicine, No 21-32-019, Report 1Google Scholar
  45. Payne RB, Osier DR, Tomlinson PAS (1953) The effects of certain motion sickness preventatives upon navigator efficiency. USAF School of Aviation Medicine, No 21-1601-0004, Report 1Google Scholar
  46. Physicians’ Desk Reference (2000) Montvale, NJ: medical economics company, 54th ednGoogle Scholar
  47. Pingree BJW, Pethybridge RJ (1989) A double-blind placebo-controlled comparison of hyoscine with early administered cinnarizine in increasing tolerance to a nauseogenic cross-coupled motion challenge. Pharm Med 4:29–42Google Scholar
  48. Pingree BJW, Pethybridge RJ (1994) A comparison of the efficacy of cinnarizine with scopolamine in the treatment of seasickness. Aviat Space Environ Med 65:597–605Google Scholar
  49. Putcha L, Berens KL, Marshburn TH, Ortega HJ, Billica RD (1999) Pharmaceutical use by U.S. astronauts on space shuttle missions. Aviat Space Environ Med 70:705–708Google Scholar
  50. Pyykko I, Padoan S, Schalen L, Lyttkens L, Magnusson M, Henriksson NG (1985) The effects of TTS-scopolomine, dimenhydrinate, lidocaine, and tocainide on motion sickness, vertigo and nystagmus. Aviat Space Environ Med 56:777–782Google Scholar
  51. Reason JT, Brand JJ (1975) Motion sickness. Academic Press, New YorkGoogle Scholar
  52. Regan EC, Ramsey AD (1996) The efficacy of hyoscine hydrobromide in reducing side-effects induced during immersions in virtual reality. Aviat Space Environ Med 67:222–226Google Scholar
  53. (Stuttgart)Google Scholar
  54. Schmedtje JF Jr, Oman CM, Letz R, Baker EL (1988) Effects of scopolamine and dextroamphetamine on human performance. Aviat Space Environ Med 59:407–410Google Scholar
  55. Schmitt MN, Shaw JE (1981) Comparison of transdermal and intravenous administration of scopolamine. Clin Pharmacol Ther 29:282Google Scholar
  56. Schwab RS (1954) The nonlabyrinthine causes of motion sickness. Int Rec Med Gen Pract Clin 167(12):631–637Google Scholar
  57. Silberman WS (2003) Medications in civil airmen: what is acceptable and what is not. Aviat Space Environ Med 74:85–86Google Scholar
  58. Simmons RG, Phillips JB, Lojewski RA, Wang Z, Boyd JL, Putcha L (2010) The efficacy of low-dose intranasal scopolamine for motion sickness. Aviat Space Environ Med 81(4):405–412Google Scholar
  59. Smith BH, Bogoch S, Dreyfus J (1988) The broad range of clinical use of phenytoin: biolectric modulator. Dreyfus Medical Foundation, New YorkGoogle Scholar
  60. Stern RM, Uijtdehaage SHJ, Muth ER, Koch KL (1994) Effect of Phenytoin on vection-induced motion sickness and gastric myoelectric activity. Aviat Space Environ Med 65:518–521Google Scholar
  61. Stott JRR (1991) Management of acute and chronic motion sickness. In: Motion sickness: significance in aerospace operations and prophylaxis. AGARD Lecture series no 175, AGARD-LS-175, North Atlantic Treaty Organization Advisory Group for Aerospace Research and Development, Neuilly-sur-Seine, France, vol 11, pp 1–7Google Scholar
  62. Stott JRR, Hubble MP, Spencer MB (1984) A double blind comparative trial of powdered ginger root, hyoscine hydrobromide, and cinnarizine in the prophylaxis of motion sickness induced by cross coupled stimulation. In: Motion sickness: mechanisms, prediction, prevention and treatment. AGARD conference proceedings No 372 (AGARD-CP-372), North Atlantic Treaty Organization Advisory Group for Aerospace Research and Development, Neuilly-sur-Seine, France, vol 39, pp 1–5Google Scholar
  63. Tokola O, Laitinen LA, Aho J, Gothoni G, Vapaatalo H (1984) Drug treatment of motion sickness: scopolamine alone and combined with ephedrine in real and simulated situations. Aviat Space Environ Med 55:636–641Google Scholar
  64. Tyler DB (1946) Influence of placebo, body position and medication on motion sickness. Am J Physiol 146:450–466Google Scholar
  65. Tyler DB, Bard P (1949) Motion sickness. Physiol Rev 311–369CrossRefGoogle Scholar
  66. Uijtdehaage SHJ, Stern RM, Koch KL (1993) Effects of scopolamine on autonomic profiles underlying motion sickness susceptibility. Aviat Space Environ Med 64:1–8Google Scholar
  67. van Neuten JM, Janssen PAJ (1973) Comparative study of the effects of flunarizine and cinnarizine on smooth muscles and cardiac tissues. Arch Int Pharmacodyn Ther 204:37–55Google Scholar
  68. Wang ET, Zhou DR, He LH (1992) Histaminergic response to Coriolis stimulation: implication for transdermal scopolamine therapy of motion sickness. Aviat Space Environ Med 63:579–582Google Scholar
  69. Weerts AP, Pattyn N, Van de Heyning PH, Wuyts FL (2014) Evaluation of the effects of anti-motion sickness drugs on subjective sleepiness and cognitive performance in healthy males. J Psychopharmacol 28(7):656–664CrossRefGoogle Scholar
  70. Weinstein SE, Stern RM (1997) Comparison of marezine and Dramamine in preventing symptoms of motion sickness. Aviat Space Environ Med 68:890–894Google Scholar
  71. Wiker SF, Kennedy RS, McCauley ME, Pepper RL (1979) Susceptibility to seasickness: influence of hull design and steaming direction. Aviat Space Environ Med 50:1046–1051Google Scholar
  72. Wood CD (1990) Pharmacological countermeasures against motion sickness. In: Crampton GH (ed) Motion and space sickness. CRC Press Inc., Boca RatonGoogle Scholar
  73. Wood CD, Graybiel A (1972) Theory of antimotion sickness drug mechanisms. Aerosp Med 43(3):249–252Google Scholar
  74. Wood CD, Kennedy RS, Graybiel A (1965) Review of antimotion sickness drugs from 1954–1964. Aerosp Med 1:1–4Google Scholar
  75. Wood CD, Manno JE, Manno BR, Redetzki HM, Wood MJ, Mims ME (1985) Evaluation of antimotion sickness drug side effects on performance. Aviat Space Environ Med 56:310–316Google Scholar
  76. Wood CD, Manno JE, Manno BR, Odenheimer RC, Bairnsfather LE (1986) The effect of antimotion sickness drugs on habituation to motion. Aviat Space Environ Med 57:539–542Google Scholar
  77. Wood CD, Stewart JJ, Wood MJ, Manno JE, Manno BR, Mims ME (1990) Therapeutic effects of antimotion sickness medications on the secondary symptoms of motion sickness. Aviat Space Environ Med 61:157–161Google Scholar
  78. Woodard D, Knox G, Myers KJ, Chelen W, Ferguson B (1993) Phenytoin as a countermeasure for motion sickness in NASA maritime operations. Aviat Space Environ Med 64:363–366Google Scholar
  79. Wovters L, Amery W, Towse G (1983) Flunarizine in the treatment of vertigo. J Laryngol Otol 97:697–704CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.National Biodynamics Laboratory, College of EngineeringUniversity of New OrleansNew OrleansUSA

Personalised recommendations