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Article Topic
April, 1998

Seasickness
Prevention and Treatment


What can you do to prevent or control seasickness when out on the ocean?

As symptoms advance, stomach awareness turns to nausea, the face becomes pale, particularly around the nose and mouth, and hands and face become cold and clammy. Belching, salivating and flatulence are common. Concentration on mental tasks becomes difficult. Eventually nausea comes in waves, and increases in uncontrolled crescendo leading almost inevitably to vomiting. Subsequent attacks of vomiting typically develop with less warning than the first.

Before departure, review procedures for prevention and treatment with your entire crew. Designation a narrow sea berth aft for use by the afflicted and have a supply of emesis bags, disposable towels, easily opened juice or water bottles and candy available in the bunk. Bags really are far superior to the traditional bucket. Airline bags are adequate, but even are the inexpensive "sic sacs" available at aviation stores. These are much easier to use in a motion environment even when lying down.

One prescription drug of interest to sailors is an adhesive patch worn behind the ear, which continuously administers a dose of the drug scopolamine through the skin over a three-day period. The idea is to try to minimize the incidence of side effects by maintaining a relatively constant level of scopolamine in the blood. The patch has been sold in the United States as Transderm-Scop only by prescription, but it has been available without one in Bermuda and in many provinces in Canada. It was taken off the market due to production problems, but at press time the manufacturer expected to make the patch available by late 1996.

NASA astronauts now generally avoid oral and transdermal premedication and rely on intramuscular injection of promethazine for treatment. The injections leave a painful sore spot and may make you very sleepy. But when combined with bed rest, injected promethazine can give fast and effective relief, and the dose is not lost if the person vomits again. Use of injectables may make good sense when sailing offshore, but you must have a person aboard who is properly qualified to prescribe and administer them. A more practiced, but slower-acting alternative is the rectal suppository. However, remember that suppositories, too, require a prescription (in the United States) and can become difficult to use unless stored in a cool place.

Finally… The moral of this story is that you can do a great deal to prevent and treat seasickness when you know its causes. Coupling of the balance brain to the emetic brain is a universal human response to any abnormal motion environment. Susceptibility only disappears when your balance brain learns to anticipate subconsciously the next wave. Drugs can be of real value until you adapt. So too can techniques such as wave riding and horizon viewing, provided you recognize and react to your earliest symptoms. If you do become severely sick, there are importantly thing you can do to make the experience less unpleasant and to assure a prompt recovery. Over the long term, the best way to prevent seasickness, aside from staying ashore, happens to be the most enjoyable: Go sailing a lot.

Useful Anti-Motion Sickness Drugs

Generic Name
Brand Name  (Manufacturer)
Form
(OTC/Rx)
Duration of Action
Dimenhydrinate
Dramamine   (Searle)
tablet (OTC)
liquid (OTC)
injection (Rx)
4-6 hr
4-6 hr
4-6 hr
Dimenhydrinate
Dramamine  (Richardson)
chewable tablet (OTC) 4-6 hr
Dimenhydrinate
Gravol (Horner)
timed-release
capsule (OTC:B&C)
suppository (OTC: B&C)

6 hr
6 hr
Meclizine HC1
Bonine  (Leeming)
chewable tablet (OTC) 6-12 hr
Meclizine HC1
Antivert  (Roerig)
tablet (Rx) 6-12 hr
Meclizine HC1
Meclizine  (Geneva)
tablet (OTC) 6-12 hr
Cinnarizine
Stugeron  (Janssen)
tablet (Rx: UK&B) 6-12 hr
Cyclizine
Marezine  (Burrough)
capsule (OTC)
injection
4-6 hr
4-6 hr
Transdermal Scopolamine
Transderm-Scop (CIBA)
skin patch (Rx, OTC: B&C) 2-3 days
Promethazine
Phynergan  (Wyeth)
tablet (Rx)
suppository (Rx)
injection (Rx)
6-12 hr
6-12 hr
6-12 hr
Promethazine & Ephedrine
Phernergan + Ephedrine (Wyeth)
tablet (Rx) 6-12 hr

OTC: over the counter
Rx: by prescription only
OTC (B&C): OTC in Bermuda & Canada
OTC (UK&B): OTC in UK & Bermuda


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