Treatments

Dealing with car sickness, a form of motion sickness, can be addressed using non-prescription solutions. Be sure to consult your healthcare provider before selecting any medication. Some options for treatment are:

• Benadryl (Diphenhydramine)
• Dramamine (Dimenhydrinate)
• Bonine, Dramamine Less Drowsy (Meclizine)

Prescription Medications

If over-the-counter remedies do not provide relief, it is advisable to see your healthcare provider. Prescription drugs for motion sickness can include:

• Meclizine – prescribed for dizziness and motion sickness
• Promethazine – used to alleviate car sickness
• Scopolamine – available in patch form, leading to drowsiness and blurred vision

Tips and Natural Remedies

In addition to medications, there are several natural remedies and tips that can help alleviate car sickness:

• Avoid engaging in activities that may worsen symptoms
• Choose a seat at the front by the window
• Focus on the horizon or close your eyes
• Stay hydrated and opt for light meals
• Avoid smoking, alcohol, or drugs
• Keep yourself engaged with music or conversation
• Practice deep breathing or meditation
• Consider using ginger or green apples for nausea relief
• Try using acupressure bracelets

It is important to discuss car sickness with a healthcare provider, especially for pregnant individuals, as some medications may not be safe during pregnancy. Seek medical attention if symptoms suddenly worsen or persist.

Findings

New research has examined the effectiveness of antihistamines for preventing and treating motion sickness.

Studies

Studies have compared antihistamines with placebos or other treatments for motion sickness.

Results

Antihistamines are believed to be more effective than placebos in managing motion sickness. However, there are still uncertainties regarding their effectiveness compared to other medications and non-drug therapies.

Review

A recent review updated as of December 7, 2021, has provided insights into motion sickness and the use of antihistamines for its treatment.

Objective

To evaluate the effectiveness of antihistamines in preventing and treating motion sickness.

Strategy

Search through various databases for relevant trials up to December 7, 2021.

Criteria

Include randomized controlled trials in susceptible adults and children to compare antihistamines with placebos or other interventions.

Conclusion

Research shows conflicting evidence on the efficacy of antihistamines for motion sickness. Further studies are needed to clarify their benefits.

Antihistamines vs. scopolamine

The efficacy of antihistamines in preventing motion sickness compared to scopolamine is still uncertain. More research is needed to determine the effectiveness of each treatment.

Antihistamines vs. antiemetics

Comparison between antihistamines and antiemetics for preventing motion sickness shows minimal differences. Further studies are required to explore their effectiveness.

Antihistamines vs. acupuncture

The impact of antihistamines on preventing motion sickness compared to acupuncture remains uncertain. Additional research is necessary to understand the efficacy of these treatments.

Authors’ conclusions

First-generation antihistamines are likely to be effective in reducing motion sickness symptoms in susceptible adults compared to placebos. However, more research is needed to determine their effects on existing symptoms and in children. The certainty of evidence for other outcomes is low, highlighting the need for further studies.

Citation

Karrim N, Byrne R, Magula N, Saman Y. Antihistamines for motion sickness. Cochrane Database of Systematic Reviews 2022, Issue 10. Art. No.: CD012715. DOI: 10.1002/14651858.CD012715.pub2.

For children prone to car sickness, taking preventive measures is essential during travel. Adapting their visibility, reducing sensory inputs, managing snacks, and ensuring fresh air circulation can all help alleviate symptoms. In cases where necessary, medications like dimenhydrinate or diphenhydramine may be considered after consulting a healthcare provider. Techniques such as taking breaks, lying down, and using cool cloths can also provide relief. If car sickness persists, it is advisable to seek guidance from a healthcare provider for appropriate solutions.

Healthcare professionals should educate travelers on managing motion sickness while traveling internationally. Symptoms of motion sickness can occur in various modes of transportation, and both preventive measures and medications can be effective in alleviating symptoms.

Background

Motion sickness has posed a challenge for centuries, stemming from different travel forms. Strategies such as enhancing visibility, reducing sensory stimuli, choosing suitable foods, and promoting ventilation can assist in symptom management. While medications like dimenhydrinate and diphenhydramine can provide relief, it’s advisable to consult a healthcare provider. Methods for alleviating symptoms include taking breaks, lying down, and using cool cloths for comfort.

In addition to the mentioned strategies, staying hydrated and avoiding heavy meals before travel can help prevent motion sickness. Ginger supplements or tea have also been found to be effective in reducing symptoms. It’s important to sit in a forward-facing position and focus on a fixed point in the distance to help stabilize your senses.

Signs and symptoms

The primary symptoms of motion sickness encompass nausea, vomiting, drowsiness, gastrointestinal discomfort, increased salivation, bodily warmth sensations, dizziness, facial pallor, and cold sweating. Symptoms manifest gradually and vary based on stimulus intensity and individual susceptibility. Progression of symptoms often begins with stomach awareness and warmth, escalating to nausea and vomiting. Virtual reality systems may induce additional symptoms like eyestrain and headaches compared to real-life experiences.

Box 7.6.1

Motion sickness signs and symptoms

• Loss of appetite
• Apathy
• Blurred vision or eyestrain
• “Cold sweating” (facial pallor and sweating)
• Difficulty concentrating
• Dizziness
• Drowsiness and fatigue
• Facial pallor
• Feelings of warmth
• Gastrointestinal discomfort
• Generalized discomfort
• Headache
• Hyperventilation
• Increased sensitivity to odors
• Nausea
• Salivation
• Sweating
• Vertigo
• Vomiting and retching
• Increased heart rate
• Shivering

Mechanisms and theories

The sensory conflict theory stands as the prevailing explanation for motion sickness. It revolves around discrepancies among vestibular, visual, and kinesthetic inputs and anticipated patterns. Internal models predict these patterns, and inconsistencies activate brain centers, triggering symptoms. Countermeasures aim to reduce sensory mismatches and foster adaptation to new sensory relationships.

Table 7.6.1: Behavioral countermeasures against motion sickness

Summary

In addition to habituation, there are limited options for treating motion sickness effectively.

Individual susceptibility and risk factors

Motion sickness is rare in children under 2 years old. Susceptibility is highest between 7 and 12 years old, decreases in adulthood, but may increase in old age. Women are generally more susceptible than men, particularly due to hormonal factors. Those with migraine, vertigo, or vestibular disorders are at higher risk. Genetics also play a significant role in susceptibility.

Other factors that can increase susceptibility to motion sickness include lack of exposure to motion, such as in individuals who rarely travel or have limited experience with activities like boating or flying. Anxiety and stress can also contribute to motion sickness symptoms, as can certain medications and underlying health conditions.

Behavioral and other nonpharmacologic countermeasures

Effective strategies for managing motion sickness include being aware of triggers, avoiding them, and using behavioral techniques such as distraction and controlled breathing. Symptoms can worsen with sleep deprivation, alcohol, and smoking. The effectiveness of dietary changes, supplements, and ginger is uncertain. Medication is recommended for one-time or occasional trips.

Pharmacologic countermeasures

Various drugs like antimuscarinics, antihistamines, and sympathomimetics can be used to treat motion sickness. Timing of medication is important, as some drugs may not be effective due to their mechanisms of action. A list of commonly used medications for motion sickness is provided in Table 7.6.2.

These medications may have side effects and contraindications, including drowsiness, dry mouth, and dry eyes. The sedative effects vary among medications, with scopolamine being less sedating than dimenhydrinate or meclizine, and promethazine being the most sedating. It is advisable to try medications before travel to gauge individual reactions. Tablets should be taken early for proper absorption, and cruise operators may forecast sea conditions.

For adults, different medications are recommended based on the level of stimulus exposure: meclizine or dimenhydrinate for mild to moderate, promethazine for intense exposure. Scopolamine patches are recommended for moderate to intense exposure over longer periods.

There are various formulations and dosages of anti-motion sickness drugs available. Behavioral interventions should be attempted initially. Use caution when administering medication to children, as different drugs are recommended based on age.

If symptoms persist after motion exposure, it may indicate a rare condition called mal de debarquement. Severe cases should be referred to a specialist. Healthcare providers should rule out other potential causes of symptoms and provide supportive care, including hydration and alternative methods of drug administration if necessary. Behavioral strategies can also be helpful in managing acute motion sickness.