Park, who works with those in training to be U.S. Navy flyers, relies on conditioning more than medication and says most of his subjects develop increased tolerance after a few wild flights. "One of the best countermeasures for motion sickness is adaptation," says Catherine Webb, a research psychologist with the U.S. Army Aeromedical Research Laboratory in Fort Rucker, Ala. She notes that about 95 percent of people will eventually adapt to a motion environment, citing single-day intervals between brief motion sessions as the optimal pacing.
Locke agrees desensitization can work—you can "get your sea legs," he says—but the time that such training requires has proved impractical given astronauts' busy premission schedules. It would also be tough, he suspects, for the typical civilian's sailing excursion or dive trip, and unpredictable conditions could work against the desired outcome. And as Webb notes, adaptation can be quickly lost if exposure or training are not continued.
Also, Locke is not convinced that being in control or using biofeedback are effective. In experiments with the motion sickness–inducing chair, he has not seen any difference in results based on a subject's well-being or mental state. "It doesn't matter how they feel before the test," he says. "An individual hits the point [of feeling sick] at the same time every test."
Studies of nondrug remedies such as consuming ginger and wearing wristbands that have pressure pads on them have not provided clear results. "The trick is that you have to test properly under controlled conditions to find out what works," Locke says. And so far, in his opinion, these alternative treatments have not been rigorously tested.
Sick or sleepy
Currently available medications to treat motion sickness suppress vestibular sensations or other brain processes, so as a rule, they make people drowsy or otherwise impaired. Scopolamine, for example, can cause drowsiness and dry mouth. It also affects vision, although a recent study reported that these effects did not seem to be clinically important. Scopolamine's side effects increase with repeated use and with age; Locke says elderly people can become delirious or even psychotic when taking it.
Side effects of rizatriptan can include fatigue, sleepiness, dizziness and nausea. Promethazine, or Phenergan, a traditional antinausea medication Locke has studied, is also sedating. In tests, people who took it were fairly impaired but did not seem to be aware that they were.
The type of medication, its dosage and the timing of its administration are key to maximizing effectiveness and minimizing side effects. But, Locke says, most physicians are not well versed in such details in the treatment of motion sickness.
"There's not a lot of information out there, and much of what does exist is wrong," Locke says. "So far, there's no magic bullet." Future studies could develop algorithms for the most effective and least side effect–inducing strategies for dosing, he says. Also, more research is needed on other fronts, including more conclusive studies to test theories on why motion sickness occurs; treatment for unpredictable situations translated from controlled ones; well-designed studies to test the efficacy of alternative treatments. In addition, studies could fine-tune methods of administrating medicines and develop guidelines for medical practitioners; evaluate the effects of age on motion sickness susceptibility; and identify new and better agents for treating motion sickness, including non-pharmacologic ones. "We could gain a lot from work to identify better agents," Locke says, "and to look specifically at more effective use of existing medications."
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14 Comments
Add CommentJames Locke is quoted:
Reply | Report Abuse | Link to this"...But [riding] in an airplane or car, your inner ear signals that you're moving, but your eye says you're sitting still."
I wonder if simply looking out a window to focus on the external environment (which contains clues of your motion) might relieve symptoms?
My wife (who also gets migranes) has had some success with the sharper image battery powered watch. It sends a small electrical charge into your wrist and can be set to different intensities. She has found it useful on flights (and cruises, although wearing it can get uncomfortable after several hours.), and she says it helped with nausea during pregnancy some as well.
Reply | Report Abuse | Link to thisWhen sharper image closed, this watch (with the replacable battery) became available only in Europe, but can be bought in the US still as a disposible watch (a scam by the new owner of the technology to get you buy it over and over again)... they advertise it now for people undergoing cancer treatments to help with the nausea, so I guess they figure insurance will just pay for it over and over... when the original design was fine (you could just pop in new batteries)... gotta love the "free" market!
At any rate, we've had several other people borrow it and it worked for them as well... it certainly beats getting drugged up.
"But like motion sickness, scientists do not really know why people get migraines . . . ."
Reply | Report Abuse | Link to thisSo motion sickness doesn't know why people get migraines? And scientists are like motion sickness? Alas for the days when the prose in SA was as good as the science coverage.
Epinewton, used for epilepsy, works particularly well against motion sickness. Use 3.5mg Epinewton per 1 kg of bodyweight two hours before being subjected to the cause of the motion sickness. There are no side effects like with most other drugs used against motion sickness.
Reply | Report Abuse | Link to thisThere was a theory a few years ago that motion sickness was an evolutionary adaption to the danger of eating poisonous alkaloid berries. Disorientation of movement and vision was a symptom of such poisoning. Vomiting as a reaction to that dislocation of the senses was therefore a successful survival strategy.
Reply | Report Abuse | Link to thisFor myself open boats at sea and soft-sprung coaches will do it. Also any motion where I can't easily focus: swings; roundabouts; car side-window views of hedges. Even walking quickly through a sequence of strong shadows of trees or vertical railings gives instant nausea. "Avomine" used to be the sure-fire preventative - although on one occasion it left me like a zombie after an afternoon being driven along hedge-lined, zig-zagging country roads at high speed.
My migraines seem to have moderated with age. Eating something fatty at the zig-zag rainbow vision distortion stage seems to prevent the usual blinding headache and nausea.
One hardly needs research to draw these conclusions.Since vertigo results from the two systems being out of synch, the solution can only be one of the following: 1)the systems need to be in synch, put in synch, or prevented from getting out of synch or 2) one or other or both systems need to be suppressed to prevent or alleviate symptoms, but without causing unwanted side effects.Since the variables are nearly infinite, the search for a "cure" for vertigo is a fool's errand.
Reply | Report Abuse | Link to thisI get world class motion sickness, takes most of the fun out of sailing or kayaking. (I also have migraines)
Reply | Report Abuse | Link to thisThere is no question that if I can keep my attention focused on the horizon line, I don't get sick. Just looking down to take a fish off a hook, however, is enough to do the trick. The speculation that keeping the attention on the fixed horizon reduces the conflict between the inner and outer signals seems right on to me.
Traversing the Atlantic by sea three times in the early 1950s, I found that I was nauseous on the first day of each voyage, but then a small upchuck got me my "sea legs," the same phenomenon occurring on the old flying boats on which we used to fly to Bermuda. No need for airsickness bags on jets, so those make nice lunch bags if you get off the plane with unused ones.
Reply | Report Abuse | Link to thisI am somewhat surprised that there is no mention of Dramamine for this condition as that is hugely effective and over the counter. One need not drop Scopalamine which is surely more risky than Dramamine which works excellently in my experience. I can take it and manage to eat with gusto on a rough plane flight when otherwise..well..we need not go into details! It affects one's vision somewhat and can be a soporific but it is surely better than having one's head in a sickbag.
Reply | Report Abuse | Link to thisThe article hints that there is no quick fix using most known medications. It is mostly in the head.
Reply | Report Abuse | Link to thisOnce when at an amusement park, inside a vertical axis cylinder I was able to exit before the compulsory waiting period after the ride stopped.
I had forced my head around 180 degrees, facing outwards, while strapped in for the last few revolutions of the ride and it briefly amplified the spinning effect. I then turned my head back to face the center and was able to walk out without any ill effects of dizziness.
Elsewhere it maybe genetic, but I believe it is still a learned adaptive behaviour. Native people who work at high elevations accept warning signals from normal swaying.
Erratic driving was probably what often made my oldest daughter carsick except when she said she was riding with me. I had taken extensive care to perform all motions predictably and in anticip[ation of wind gusts, curves, starts and stops, once even through a forbidding snowstorm. She now no longer complains of carsickness with anyone.
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Reply | Report Abuse | Link to thisMotion sickness is caused by exposure to infrasound.
Reply | Report Abuse | Link to thisMotion sickness is caused by exposure to infrasound.
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