Don’t let Motion Sickness Ruin your Summer Adventures.
- Christine Daecher, DO
- May 7
- 4 min read
As someone who has experienced severe, lifelong motion sickness, I truly empathize with others who suffer from it. Below is a summary of both over-the-counter, prescription, and nonpharmacologic treatment options.
Motion sickness most likely arises when the stimuli received by the vestibular, visual, and proprioceptive systems are in conflict.
Antihistamines
Dramamine (dimenhydrinate) is an H1 antihistamine available in both prescription and over-the-counter (OTC) forms. (Note: Prescription dimenhydrinate is typically administered by injection and will not be discussed here.) As an antihistamine, it may cause drowsiness due to its central nervous system (CNS) depressant effects.
Dimenhydrinate has several pharmacologic actions: it is a CNS depressant, anticholinergic, antiemetic, antihistamine, and also has local anesthetic properties. It’s important not to take other antihistamines concurrently, as doing so can increase the risk of antihistamine toxicity.
This medication is FDA-approved for the prevention and treatment of motion sickness. For best results, it should be taken prophylactically, at least 30 minutes before engaging in activities likely to cause symptoms. OTC tablets are available in 50 mg doses, and the typical adult dose is 1 to 2 tablets by mouth every 4 to 6 hours as needed, not to exceed 400 mg per day (i.e., up to 2 tablets, 4 times daily).
Personally, I’ve tried dimenhydrinate with mixed results. While it provides some relief and I would use it if no better options were available, I don’t find it to be the most effective treatment for my motion sickness.
Promethazine (Phenergan) is another antihistamine that can be used to treat motion sickness. However, it requires a prescription and is generally more sedating than dimenhydrinate.
Meclizine is an antihistamine often used for vertigo and it may be used for motion sickness but it is not preferred as it does require a prescription.
Anticholinergics: Scopolamine patches and intranasal spray
Scopolamine requires a prescription and typically involves a visit to the doctor. While it is often not covered by insurance, as of the time of writing this blog, you can purchase approximately four patches for around $30 with a GoodRx coupon. Each patch provides protection for 72 hours and is applied behind the ear. The first patch should be placed 4 to 12 hours before motion exposure, with 12 hours being ideal for maximum effectiveness.
In my experience, the scopolamine patch is extremely effective for preventing motion sickness. However, the side effects can be bothersome—or even severe for some people. Common adverse effects include dry mouth (reported in 29% of users), as well as dryness of the nose and eyes. Personally, I’ve found the dryness in my nasal passages to be so intense that I would sneeze frequently—up to 15 times a day, sometimes in long fits of 10 or more sneezes while wearing the patch.
Additionally, about 12% of users report dizziness as a side effect. As I’ve gotten older, I’ve noticed that side effects have become more pronounced, and in one case, I experienced lingering symptoms that lasted up to six weeks after removing the patch.
Acetazolamide (Diamox)
Acetazolamide is a diuretic commonly used to treat glaucoma by reducing the production of aqueous humor, thereby lowering intraocular pressure. In the kidneys, it works by inhibiting hydrogen ion (H⁺) excretion in the renal tubules, which leads to increased excretion of sodium, potassium, bicarbonate, and water, resulting in an alkaline diuresis. Acetazolamide also inhibits carbonic anhydrase activity in the central nervous system (CNS), which may reduce abnormal neuronal discharge.
For travel, acetazolamide is most often used to prevent altitude sickness. It helps by inducing a mild metabolic acidosis, which stimulates increased respiratory rate, thereby improving blood oxygenation—a key factor in acclimatizing to high altitudes.
The use of acetazolamide for motion sickness is considered off-label and alternative. It is, however, used to treat Ménière’s disease, an inner ear disorder characterized by increased vestibular sensitivity, which shares some overlap with motion sickness symptoms. One possible mechanism of combating motion sickness is by a diuretic effect to the inner ear.
From my personal experience, when I took acetazolamide for a trip to high elevation, I was surprised to experience no motion sickness at all, even on winding roads that would normally trigger symptoms. Upon returning, I looked into the evidence and found that research on acetazolamide for motion sickness is scant. While there are some theoretical and anecdotal reasons to believe it may help in some instances, there is not enough data to recommend it as a standard treatment for motion sickness at this time. It may be a good choice for a traveller who will be visiting high elevation areas.
Non-pharmacological treatments
Several strategies can help prevent or reduce motion sickness. While they’re better than doing nothing, I wouldn’t rely on them alone to get me through a vacation or boat ride.
Courtesy of Brainard, A. Motion Sickness Treatment & Management. Medscape. 2024 Jan 4. Reliefband®
I've saved the best for last. Expensive but worth it—the Reliefband® uses neuromodulation by delivering gentle electrical pulses to the median nerve at the wrist, which helps regulate nausea signals in the brain. It can be worn proactively before motion sickness begins, or after symptoms have already started. If you have a Flexible Spending Account (FSA) or Health Savings Account (HSA), you may be able to reimburse the cost or use your card directly for the purchase.
I recently tested the Reliefband® on a deep-sea fishing trip in the Gulf of Mexico. I didn’t take any other motion sickness medications. Just before boarding the boat, I even rode as a passenger and read the entire trip without feeling the slightest bit of queasiness. I was genuinely shocked (in more ways than one) at how well it worked.
Commenti