How to treat seasickness

What treatments did seasick crews use?

This is a follow-up to the comprehensive survey we did with over 200 crews on the 2004/5 Global Challenge Race, the largest survey into seasickness while sailing that has been published to date.

In this part of the survey we looked at who suffered from mild seasickness that lasted a day or less took nothing for it. The Challenge medical advisers recommended a ‘multi-modal’ approach, whereby two or more different types of medication are taken simultaneously to work on different stimulation pathways, and they advocated early medication, 12-24 hours before going to sea.

While a number of crewmembers on one yacht took cinnarizine (Stugeron) and domperidone (Motilium) in combination – the medic on board noted a synergistic effect – single remedies were more commonly taken. Which single drug was favoured varied from boat to boat depending on the treatment culture of individual yachts (see below).

On one yacht, domperidone (Motilium) was widely favoured, on another cyclizine (Dramamine II), on a third promethazine (Avomine). But most crews stuck to cinnarizine (Stugeron) or hyoscine patches (Scopoderm) and, judging from some medics’ comments, had arrived at whichever they favoured by trial and error.

The most effective remedy, taking into account sample sizes of each, appears to have been hyoscine patches – half of the 20 users said it ‘helped a lot’. Cinnarizine was more evenly split between ‘helps a little’ (35 per cent) and ‘helps a lot’ (35 per cent).

Side-effects were noted by a number of crew. Cinnarizine caused drowsiness and in one case was said to be ‘totally debilitating’. Hyoscine patches caused blurred vision, skin reaction or a dry mouth and one medic noted dry eyes as a problem with contact lenses.

Other drugs used for the most severe cases were ondansetron (Zofran), which was ‘the only drug that was able to retrieve people who had started vomiting’, and prochlorperazine (Buccastem).

Seasickness medication explained:

Cinnarizine
Antihistamine also used to treat inner ear problems such as vertigo. Blocks receptors in the vomiting centre of the brain.
Side-effects: Drowsiness and inability to concentrate
Sold as: Stugeron

Cyclizine
Another antihistamine that blocks receptors in the vomiting centre of the brain and tightens muscles to stomach.
Side-effects: Drowsiness
Sold as: Dramamine II, Marzine

Domperidone
A dopamine-receptor blocking agent that tightens the muscles at the entry to and exit from stomach and increases contraction of muscles in the stomach itself. This speeds the passage of food through to the intestine, helping to prevent vomiting.
Side-effects: Dizziness
Sold as: Motilium

Hyoscine (or scopolamine)
Works on receptors that cause the gut muscle to relax. Absorbed in minute doses through the skin via an adhesive patch. In larger doses hyoscine is highly toxic and the CIA investigated it as a truth drug in the 1950s but abandoned the project. Criminally used as a date rape drug because of its ability to cause retrograde amnesia.
Side-effects: Dry mouth, blurred vision
Sold as: Scopoderm, Transderm

Promethazine
Another antihistamine used to treat inner ear problems, which blocks receptors in the vomiting centre of the brain.
Side-effects:Drowsiness, dry mouth
Sold as: Avomine, Phenergan

Also used: prochlorperazine (Buccastem), metoclopramide (Maxolon); ondansetron (Zofran).