What’s The Best Treatment For Seasickness? Part I, What Won’t Work Well

While stocking up on key items for our Galapagos cruise, the eternal fiancée of the skeptical cardiologist (EFOSC) bought an item that set off the skeptical cardiologist’s (extremely sensitive) BS detector.

Once I began looking into the seasickness treatment options and science I soon realized that the vast majority of OTC medications, patches and devices offered are snake oil.

There is one highly effective treatment which requires a prescription, one possibly effective OTC treatment which will likely put you to sleep, and one very slightly effective treatment which will also likely put you to sleep.

First let’s look at the totally bogus patch Jen purchased.

It calls itself a “motion sickness patch.” It is manufactured in China. (Somebody should put a tariff on this junk!)

It also carries the allure of being natural which people (mistakenly) assume means free of side effects.

Since most people have heard of an effective motion sickness patch, they naturally assume that this is legitimate. 

It appears to be highly rated on Amazon with 80% of over a thousand reviewers giving it 4 or 5 stars. However, 10% of reviewers give it 1 star, usually commenting that the MQ patches were useless  and were purchased as they were cheaper than the prescription patch that worked for them before.

And it is no surprise that it doesn’t work for many because the ingredients would not be expected to have any effect on motion sickness.

The main Ingredient are listed as

safflowertall,gastrodia,tuber,sanchi,hairy datura flower,borneol,pinellia tuber,obtuseleaf cinnamon bark,frankincense,dahurian angelica root,etc.

Yes, in these patches you get the added bonus of “etc.” in the formulation!

In case you needed more explanation of how this works, check out the bizarre “working theory” of the mysterious ingredient’s efficacy:

Working theory
1. Adjust the control of the vagal nerve to gastrointestinal tract, inhibit the motility of the gastrointestinal, thus preventing nausea and vomiting.
2. By expanding the capillaries of the skin, to improve the microcirculation of body and increase the amount of oxygen to brain, thus comes to the effect of refreshing your brain.

All I can say about those who have experienced relief with this MQ nostrum is “the placebo force is strong with you!”

After reading the reviews for the MQ patch and  listening to an NPR story on paid Amazon product reviews  my faith in Amazon product reviews is at an all time low.

Similarly, most of the sites on the internet which promise to give you the top 10 products in a certain area I have found to be bogus. For example, the amazingly useless MQ motion sickness patch is ranked #5 on the “Best Reviews” Guide to Motion Sickness.

Bonine

The second product the EFOSC purchased online was the oddly-named Bonine.  Bonine is the brand name for meclizine, a first-generation antihistamine with anti-cholinergic properties which is often prescribed for benign positional vertigo.

There is not much evidence supporting meclizine for sea sickness but it is widely used owing to its accessibility and marketing. Like all first-generation antihistamines, it will make you drowsy. Before the second generation, non-sedating antihistamines were introduced, I would walk around in a zombie-like state when my allergies required an antihistamine.

Keep in mind you can get a prescription for 30 tablets of meclizine 25 mg for about 12$.

Acupressure

More evidence that the placebo force is particularly strong in the motion sickness world is the widespread marketing, sales and testimonials to “acupressure”  devices.

The EFOSC with her Sea Band. She likes to wear it because it is blue and white, her favorite colours.

The EFOSC suffers from car sickness and several years ago purchased something called the  Sea Band.

Wrist bands like the Sea Band claim to reduce nausea and other symptoms of seasickness through stimulation of the “P6/Neiguan” acupuncture point by applying acupressure or electrical acustimulation.

These work primarily through placebo effect and studies have shown a “sham” acupressure band works as well as a real one.

One fascinating study examined  a self-fulfilling prophecy (SFP) approach to combating seasickness:

the authors experimentally augmented the self-efficacy of naval cadets by telling them that they were unlikely to experience seasickness and that, if they did, it was unlikely to affect their performance at sea. Naval cadets (N = 25) in the Israel Defense Forces were randomly assigned to experimental and control conditions. At the end of a 5-day training cruise, experimental cadets reported less seasickness and were rated as better performers by naive training officers than were the control cadets

The EFOSC is gravely concerned about debilitating seasickness during our 8 days on the Samba. To maximize the placebo force in her I should have emphasized how well the Sea Band and the MQ patch work. Hopefully she won’t read this post.

In Part 2 of the Best Seasickness Treatment I’ll discuss transdermal scopolamine and dramamine, the treatments with the best evidence for efficacy, safety and tolerability.

I’ll also examine the evidence for ginger.

What’s been your experience with sea sickness and treatments for sea sickness?

Vertiginously Yours,

-ACP

27 thoughts on “What’s The Best Treatment For Seasickness? Part I, What Won’t Work Well”

  1. Ginger seems to work the best for my husband and son in law. They seem to think it works as well as Dramamine without the drowsy affect

      1. One tablet twice a day, starting two days before boarding ship.
        Tablet is ginger extract 250mg
        Organic ginger 150mg
        Purchased at Whole Foods.

  2. When I had seasickness on a boat in choppy waters in Turks and Caicos, the ship captain gave me a warm lemon lime soda. Calmed my stomach quickly – maybe the sugar, maybe the placebo effect but I soon felt more like eating lunch than losing it.

  3. Perhaps you can address why some of us never experience sea sickness. I seem to roll with the waves and thoroughly enjoy the ride. Might the secrets to cures (or preventions) lie in discovering why some never experience the problems?

    1. Yes, and with the 180$ you pay them for their unproven wristband and ” To spread awareness and give a voice to nausea suffers, Reliefband Technologies LLC, an innovator in wearable technology that controls nausea, has created National Stop Nausea Day”

      1. I notice we’re in the middle of unproven here, so might add to the options. Never tried it, nor have shares or so, but would be interested to learn others’ experience with it …

  4. The most effective antiemetic with virtually no side effects is Tigan 300mg q6hours for 24 to 48 hours. Tigan 300 should be given prophylactically a 1/2 before boarding the cruise ship. I have had Tigan prescribed successfully to family, friends, as well as myself. I always suggest that a patient take a Tigan sometime before their vacation just to access the lack of side effects.

    Bon Voyage’

  5. Nothing wrong with ‘Placebo’ effect. Physicians use it all the time and usually with good effect. Trouble with looking too closely at ‘biased’ RCTs is the prime aim of the Healer is shifted… from making folk ‘well again’ to points-scoring and ego-boosting.
    Yes, I’m quite able to discern the Snake-Oil and I’m not too proud to use ‘placebo’ on myself or others, – if it works and has limited harmful side-effects.
    ( More than we can say about elective stents, as ORBITA illuminated recently…)
    “Keep your one knee bent – and with my arms around you..WILL stop you getting seasick; – I never do !” worked for more than one damsel in distress.

    I suggest you try it instead of your manufactured chemical nostrums.

    1. James,
      It’s interesting that you condemn the RCT with one hand and praise Orbita on the other. Orbita being a fantastic example of an RCT of sham stenting versus real stenting which showed no benefit for real over sham. Any points scored or egos boosted in ORBITA were incidental to the investigators desire to answer an important scientific question.

      1. ORBITA indeed answered questions, as my first (“elective”, as were subsequent stents & CABG) stenting was a Success (self-observational physical performance) but the next two were,,,underwhelming, to put it politely.
        And the CABG-ing has, “cured” the angina, – but No improvement in real life performance. Which asks an important scientific question…
        My objection is to what I regard as ‘not-the-FULL-story deception’, either intentional or not. Recent Editors of prestigious medical journals have raised issues of Integrity, more bluntly…

        In too many fields of Modern Medicine it’s overlooked that Genuine Concern & Care multiplies the efficacy of any nostrum;
        – We anticipate your Cure for Mal de Mer. 🙂

  6. I love your range of discussion topics !

    Found this which may be of interest. Ginger has worked for me in the past, pleasant, palatable and effective. I think.
    http://www.greenmedinfo.com/article/ginger-reduces-tendency-vomiting-and-cold-sweating-due-seasickness-significant

    But a kindly and steadying hand will be of equal value to EFOSC.
    Partaking of ginger-centered Chocolate is my preferred prophylactic therapy. Whatever, it freshens the mouth !
    Play your cards right… and we may see the ‘EF’ changed to something else.!

  7. I was once told that since seasickness can be caused by the continued assault on ones semicircular canal(s), try sleeping with a different orientation to the ship’s rocking motion, like maybe sideways on the mattress, to see if this helps.

  8. I used the trans dermal patch for sea sickness for several days and I was still got sea sick.
    The captain of our Boston Whaler gave me some Dramamine as a last ditch attempt. Otherwise, he was calling the Coast Guard as I was getting dehydrated.
    Within 20 minutes, I was fine, really fine. I was able to watch the flying fish from the rail…
    And when the patch was removed, I had a rash from the adhesive.
    I’m a Dramamine user now.

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