Medical Edge Newspaper Column

Preventing Motion Sickness

August 27, 2007
Dear Mayo Clinic:
My husband suffers from severe car sickness. When traveling on roads with more than a twist or two, he becomes very nauseated, even on short trips of a mile or two. This sickness lasts the entire day. He can't eat or even close his eyes because he gets so dizzy. Is there anything he can do to avoid these episodes, short of taking medication? Dimenhydrinate (Dramamine) makes him drowsy. Since our children are grown, we have enjoyed taking road trips, but this ailment is really causing problems. -- Shoreline, Wash.

Answer:
A common problem, motion sickness often is caused by riding in a car, as in your husband's case. Boats, carnival rides, large-format movies and virtual reality rides also can bring on motion sickness. Although it's not clear why, migraine sufferers and women are more susceptible to motion sickness than others.

The problem develops when your brain receives mixed messages between what your eyes see, what your inner ear vestibular system (which controls your sense of balance) senses, and what your body's sensory system tells you about where you are and the speed and direction of your movement.

For example, a person reading in the back seat sees the inside of the car as stationary, but his inner ear senses the pull of the car around a tight corner and feels his shoulder and hip being pressed up against the door. Alternatively, the motion on a large projection screen of a virtual reality ride or large-format movie creates the visual illusion that viewer must be moving, although his seat moves not at all.

Prevention is the key to overcoming motion sickness, as it is more difficult to treat once it starts. The most effective preventive steps are often simple behavioral ones. A person prone to car sickness, such as your husband, should be the driver in so far as possible. If not driving, he should sit in the front seat with his head still, facing forward and looking out at the horizon. Reading in the back seat is the worst. Controlled regular breathing also can be helpful. Clinical trials haven't found benefit from acupuncture or acupressure devices.

Anti-motion sickness medications can be helpful but, as your husband has found, they often cause drowsiness. Dimenhydrinate (Dramamine) and meclizine (Antivert, Bonine) are over-the-counter tablets that can be taken an hour before travel. Scopolamine (Transderm Scop) patches tend to be less sedating. They are placed on the skin behind the ear before travel and can be left in place for up to three days for situations like a cruise.

-- Scott Eggers, M.D., Neurology, Mayo Clinic, Rochester, Minn.