Comparison of Seven Commonly Used Agents for Prophylaxis of Seasickness

Abstract

The objective of the study was to compare the efficacy and tolerability of seven drugs frequently used for the prevention of seasickness: the drugs were namely cinnarizine, cinnarizine with domperidone, cyclizine, dimenhydrinate with caffeine, ginger root, meclozine with caffeine, and scopolamine. The design was a randomized, double-blind study with two arms. On ethical grounds, a placebo group was not included as in a previous study, in the same setting, 80% of the passengers not receiving prophylactic drugs were seasick. The setting was in Andenes (Norway) during a time period from July to September 1992. Subjects were 1741 tourist volunteers who were joining a whale safari. The main outcome measures were vomiting, malaise (modified Graybiel criteria), and subjective reports of adverse events. Follow up was possible in 1489 volunteers (85.5%). In each active treatment group, 4.1-10.2% experienced vomiting and 16.4-23.5% experienced malaise (not significant). Equally, there was no significant difference in the incidence and characteristics of adverse events reported in the various medication groups. Scopolamine Transdermal Therapeutic System (TTS) users exhibited slightly more visual problems and the agent tended to be less effective. Six of the seven medications may be recommended for prevention of seasickness; scopolamine TTS seems the least attractive.

A Comparison of Cinnarizine and Transdermal Scopolamine for the Prevention of Seasickness in Naval Crew

“…7,8,13 Higher efficacy (80%Y90%) was observed in studies that assessed subjects participating in recreational voyages, some of whom had no known history of or susceptibility to seasickness. 4,11,12 In contrast, the subjects in our study were experienced sailors, who were relatively susceptible to seasickness and had failed to adapt to sea conditions or respond to other therapies for seasickness in the past. They are expected to carry out complex tasks at sea to the highest possible standard, and the symptoms of seasickness often make this impossible.…”

“…The fact that our study population was a demographically homogenous group of young men may also provide an explanation for the difference between the results of the present study and those conducted during recreational voyages. 11,12 A unique advantage of the present investigation over the only other study that compared the transdermal scopolamine patch and cinnarizine 12 is the crossover design. This enables the comparison of equal groups of subjects who serve as their own controls, as well as the inclusion of subjects' comments on their preferred treatment.…”

Ingwer: Gewürz und Arzneipflanze - wenig bekannte und unterschätzte therapeutische Eigenschaften

“…Eine weitere Übersichtsarbeit aus dem Jahre 2005 [12] berücksichtigte 16 Studien, davon 10 Studien, die nach Ernst und Pittler 2000 erschienen oder von diesen Autoren nicht berücksichtigt wurden [13,14,15,16,17,18,19,20]. Auch diese Studie betraf Kinetosen sowie Übelkeit in der Schwangerschaft und in der postoperativen Phase.…”

“…Neben drei positiven Resultaten [2,6,19] kamen die Autoren bei drei weiteren Studien zu einem negativen Resultat [20,23,24]. Zwei [2,19] der drei Positivstudien wurden unter realistischen Bedingungen, d.h. auf einem Schiff mit Probanden durchgeführt, die keine Meereserfahrung hatten. Dabei wurde Ingwer mit etablierten Wirkstoffen gegen Reisekrankheiten verglichen.…”

Ginger for Prevention of Antituberculosis-induced Gastrointestinal Adverse Reactions Including Hepatotoxicity: A Randomized Pilot Clinical Trial

“…The active ingredients of ginger are akaloids (e.g., gentialutine and gentianine), glycosides (anaroswerin and amaropanin), and volatile oils (bisabolene, zingiberene, gingerols, and zingiberole). The gingerols and shogaols were subsequently identified as the main antiemetic compounds (Schmid et al ., ). The exact anti‐emetic mechanism of these compounds is unknown.…”