Say “Bon Voyage” to Motion Sickness!

Posted on March 2nd, 2020 by

Written By Jessica Erskine, Hailey Campbell, Jacqui Miller, and Abby Carsten

Picture this: You’re all dressed up for an evening on a river cruise with a hot date. The stars glimmer beautifully in the water. The cool breeze is just right for snuggling up with your date. You even enjoy a shrimp cocktail as you travel through the night. It’s everything you had dreamed of. But oh. Oh no. Your stomach churns, suddenly you’re not feeling so well. You ask your date if they have any medicine. They don’t. Your head is starting to spin, but it’s okay. You think maybe you just need to get up and walk around the deck for a while, get some fresh air. It’s not getting better, but you don’t want to ruin the night. It’s just a few more hours. Think of the memories you’ll make. You can push through. Just hold on. But you can’t hold on. And all of a sudden, that shrimp cocktail makes a surprise appearance on the starboard deck.

This may not be your exact experience, but chances are you, or someone you know has had an awkward encounter with motion sickness. On the bright side, it’s reassuring to know that motion sickness isn’t contagious and that there are options to prevent it. In particular, the medication scopolamine has shown a lot of promise for those who struggle with this issue. However, before going into detail about scopolamine, let’s focus on some basic facts about motion sickness. Statistically, some are more prone to this unpleasant experience such as women, children and pregnant women (Salter, 2019). The simple fact is that motion sickness affects a large portion of people. Statistics vary, but a Popular Science article reported that “about 65% of people suffer from motion sickness” (Salter, 2019).

The symptoms experienced with motion sickness, widely vary. However, WebMD offers ten of the most common symptoms:

● Nausea
● Cold sweats
● Dizziness
● Increase in saliva production
● Loss of appetite
● Pale skin
● Headaches
● Drowsiness
● Pale skin
● Shallow breathing

Unfortunately, it’s still unclear to scientists exactly why motion sickness happens, though there are some pretty good hypotheses. Motion sickness is characterized by incongruence between the visual system and the vestibular system (a system of tiny organs in your inner ear that helps you balance and understand your place in space) (Bertolini & Straumann, 2016). If you think about riding in a car, your visual system is telling you that you are moving as you see outside objects passing by. However, your vestibular system is telling you that you’re sitting still. This creates mixed signals, and your brain typically chooses to believe your visual system over your vestibular. According to the Department of Neurology, at the University Hospital of Zurich in Switzerland, motion sickness “is a physiological response to a motion stimulus that is unexpected due to previous experience” (Bertolini & Straumann, 2016).  In layman’s terms, experience tells you that if your eyes say you’re staying still, your vestibular system should say the same thing. When they disagree, your body’s physical response is to make you nauseous. Motion sickness is your body taking action against this disagreement. This could explain why children tend to experience motion sickness less than adults because when these systems disagree – the body does not have the experience to judge which one is right.

Another way to explain this concept is that your body is reacting to a novel type of movement. This could be something like expecting the rollercoaster that you’re in to move forward, but it jerks backwards. With the presupposition that you have been on a rollercoaster before, the hypothesis concludes that because you were expecting to go forward, but then received an alternative motion stimulus, this is why you would experience motion sickness (Bertolini & Straumann, 2016).

Due to the high volume of individuals who suffer from motion sickness, the drug scopolamine has given many of them the relief they need. According to pharmacist, Omudhome Ogbru and medical doctor, Jay W. Marks, it is believed that scopolamine can prevent communication between the parts of the brain responsible for making you vomit and the nerves of the vestibular organs (Ogbru & Marks, 2019). It does this by inhibiting the action of acetylcholine. Acetylcholine is a chemical that helps nerves communicate with each other and the brain, also known as a “neurotransmitter.” Scopolamine acts like an interceptor, blocking the messages saying you’re motion sick from ever making it to the brain. Inhibiting acetylcholine prevents sweating and salivation, and also slows activity in the gastrointestinal tract, addressing several of the most uncomfortable symptoms from motion sickness (Baxter, 2013). In short, scopolamine is preventative, not doing anything to cure motion sickness, just managing the symptoms by preventing your brain from realizing what’s happening.

Scopolamine can come in pill form or as a patch. The patch demonstrates the best results because once scopolamine enters the body (as when taken by mouth), its activity lasts for only a short amount of time (Orrange, 2019). Slowly dispensing the drug in a patch form allows scopolamine to be much longer acting at a low dose, with one patch lasting up to 3 days. The patch should be placed behind the ear (an area with especially permeable skin) and should be applied at least 4 hours before its effects are needed so the drug has time to take effect. This is because it needs time to limit the communication between the nerves in the vestibular system and the brain. However, along with the benefits of scopolamine, come some downsides which can include:

● disorientation
● dry mouth
● drowsiness
● dilated pupils
● dizziness
● sweating
● sore throat

Even after these side effects, Dr. Sharon Orrange of Keck School of Medicine recommends scopolamine as the best medication to prevent motion sickness. It has several advantages over the next best options, it’s both more effective than antihistamines and does not make you sleepy while still being as effective as Dramamine (Orrange, 2019). Now, if you’re someone who deals with motion sickness, you can rest easy knowing that there is an effective tool to make your next plane trip, river cruise, or bus ride a little more comfortable.

 

References

Baxter. (2013). Transderm Scop (Scopolamine): Full Prescribing Information. Novartis Consumer Health. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/203753Orig1s000lbl.pdf

Bertolini, G., & Straumann, D. (2016). Moving in a Moving World: A Review on Vestibular Motion Sickness. Frontiers in neurology, 7, 14. https://doi.org/10.3389/fneur.2016.00014 

Brennan, D. (2016, Aug. 27). Motion Sickness: Symptoms, Causes, Treatment, Prevention. WebMD. Retrieved from https://www.webmd.com/cold-and-flu/ear-infection/motion-sickness#1 

MedlinePlus. (2019, June 15). Scopolamine Transdermal Patch. NIH. Retrieved from https://medlineplus.gov/druginfo/meds/a682509.html 

Ogbru, O., & Marks, J.W. (2019, July 8). Scopolamine, Transderm-Scop: Drug Facts, Side Effects and Dosage. MedicineNet. Retrieved from www.medicinenet.com/scopolamine/article.htm#what_is_scopolamine_what_are_the_uses_for_scopolamine 

Orrange, S. (2019, Dec. 11). What is the Best Medication for Motion Sickness? Patches vs. Pills. The GoodRx Prescription Savings Blog. Retrieved from https://www.goodrx.com/blog/best-medication-motion-sickness-patches-pills/ 

Salter, S. (2019, Sep. 10). Motion Sickness Is Proof That Your Body Is Functioning as Evolution Intended. Popular Science. Retrieved from www.popsci.com/why-humans-fish-get-motion-sickness/ 

VEDA. (2018). What Is Motion Sickness. Vestibular Disorders Association. Retrieved from https://vestibular.org/sites/default/files/page_files/Documents/Motion-Sickness_91.pdf

Xenos, E. (2018, Nov. 1). 10 Tips to Beat Motion Sickness. One Medical. Retrieved from http://www.onemedical.com/blog/get-well/motion-sickness-cures 

 

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