Stugeron seasickness medicine

I never thought I was prone to motion sickness, until I sailed on a tall sailing ship from Fiji to Vanuatu, in the so-called "Pacific" Ocean. The highly experienced New Zealand crew strongly recommended I take the anti-seasickness pill Stugeron. They said that this medication had worked best for the most crew and passengers, with the fewest side effects, for that tall ship over a period of ten years. I was reluctant to take anything, but finally obeyed orders just as the ship departed the protected waters of the Fijian archipelago, and entered rough ocean seas kicked up by a gale. I was already starting to get queasy with the violent motion, but then the Stugeron began to take effect, and I felt pretty good. I took it for a day, until I got my sea legs, then felt fine, regardless of storms, and didn't need it any more for the 18 day voyage. It did not make me drowsy or give me any side effects. I thought it was great, and have used it often since then.

This experience led me to get interested in seasickness, its prevalence and treatment. Let me share what I have found. Most scientists agree that motion sickness probably did not exist until mankind invented sea-going vessels and other modern transport. It is thus not a disease, but rather a temporary condition brought about in healthy, normal people by exposure to abnormal motions. According to the Bible of seasickness -- Motion Sickness by J.T. Reason and J.J. Brand (London: Academic Press, 1975) -- seasickness can be induced in all mammals, and even fish can get seasick! A review by the US Army Research Institute for the Behavioral and Social Sciences (Introduction to and Review of Simulator Sickness Research, 2005), found that 100 percent of humans will get motion sickness if conditions are extreme enough, but only a small percentage get sick in moderate conditions. For example, only five percent of air navigators dropped out of flight training in World War II due to on-going air sickness. About seven percent of cruise ship passengers experience seasickness, but many more than that fear seasickness and refuse to go to sea at all.

Motion sickness is not related to how tough or fit you are. Space shuttle astronauts, who spend thousands of hours in training and exercise, but who can get disoriented in zero gravity, have a 50 percent motion sickness rate during space flight. The zero gravity toilet in the shuttle even has two settings, one for normal waste, and one for vomit!

Studies of motion sickness have shown conclusively that it is associated with the functioning of the vestibular system in the inner ear. Persons who have lost their inner ear or whose inner ears do not function at all, cannot get motion sickness. Women are reportedly somewhat more susceptible than men, and children under age 2 are virtually immune. Susceptibility is high from age 2 to 12, drops fast from age 12 to 21, and drops slowly from 21 to 50. Above age 50, motion sickness is reportedly “very rare.” Good news for senior citizens.

So what can you do to counteract motion sickness, besides get older?

You can try Stugeron, like I did. This medication is not known or available in the US, but it is common in Canada, Europe and Commonwealth countries, so I buy it over the counter whenever I am abroad. The generic name is “cinnarizine” or “cinnarizin” and it is an antihistamine. I bought my current supply for 11 Swiss Francs in Zurich; this is about $10.43 US dollars. It came in a box of 25 tablets of 25 mg each, and the directions are to take one tablet before traveling, and one tablet or a half a tablet every 8 hours or so with food, until the symptoms disappear. In my experience, just 2-3 tablets and one day are sufficient to “habituate to the ship’s motion,” as the seasickness studies call it. And I only take it if the seas will be rough. Naturally, your body and your results may differ, and you should consult your doctor before taking this or any other medication. You should not combine this medication with other seasickness meds, and check for drug interactions.

You can also obtain Stugeron/cinnarizine over the counter via the Internet from Canada, for example from www.drugworldcanada.com or 866-485-7979. They have 15, 25 and 75 mg tablets available; I recommend only the two lower doses. Shipping to the US is free and legal and takes 14 to 18 days, and the cost of the medications is $30 US dollars for 100 tablets of the cinnarizine generic.

Another effective medication is the well known antihistamine Dramamine (dimenhydrinate). My wife uses this for air and sea-sickness. It makes her drowsy, but on long plane rides she likes this. A non-drowsy version of Dramamine and the similar Bonine is available.

A friend of mine had a serious problem with the other famous medication, “the patch” – or scopolamine. This derivative of jimson weed is quite powerful, as my friend discovered. She accidentally put on two patches instead of one on her neck, getting a double dose. She then suffered from hallucinations, dizziness and confusion. She could not utter a single coherent sentence, was terrified, and had to be taken off the boat and locked in a dark room for three days. I think I’ll pass on scopolamine – I’d rather be seasick.

Ship’s doctors have a medication, antidopaminergic promethazine (brands: Phenergan, Promacot), that can be injected for severe seasickness. Metaclopromide can also be injected for severe stomach cramps associated with nausea, and this takes effect in minutes.

Medications recommended for seasickness in the famous British medical journal The Lancet between 1828 and 1928 included opium, amyl nitrite, chloroform, creosote, quinine, nitrous oxide, strychnine, cayenne and cocaine! Needless to say, I don’t endorse any of these.

Some sufferers report that vitamin B6, or ginger ale, ginger snaps, ginger candy, ginger tea or pure ginger gives some relief. I have not tried these, but they can’t hurt.

A mechanical, non-medication device I like are the wrist bands that have a little button that presses on the inside of the wrist. This is supposed to be an accu-pressure point that affects the inner ear and prevents motion sickness. It sounds unlikely but I think it has helped me on occasion, so I recommend it. These cost about $10 in drug stores. I have not tried the $25 magnetic wrist bands or the $200 watch-style Reliefband which sends out electric pulses to the pressure point.

There are several ways to minimize exposure to the unusual motion that causes seasickness. One obvious way is to take a river or canal cruise, not an ocean voyage. Another is to take your first cruise in the relatively sheltered waters of the Caribbean, Inland Sea of Japan, or Inside Passage of Alaska in the summer, instead of in the open ocean in the winter. Yet a third is to choose a really large, modern vessel. When we sailed on the 1132-foot-long Queen Mary 2 we could hardly feel 15 foot waves generated by 35 knot winds. Yet these same sized waves made me a bit queasy aboard the 638-foot Marco Polo.

Modern cruise ships have excellent stabilizers which reduce roll by up to 75 percent. According to an engineer on the original Queen Mary, during some storms in the 1950s he observed the inclinometer in the engine room, which showed that the vessel was rolling past the scale maximum of 45 degrees of roll. He estimated the maximum incline at 48 degrees! The stabilizers on the modern Queen Mary 2 and other similar cruise ships make this virtually impossible.

Even small vessels are starting to fit stabilizers. The latest development is called the TRAC-STAR (STabilization At Rest) system, which can be fitted on yachts as short as 48 feet. This system, consisting of small outboard fins and a computer control, substantially reduces roll while underway, and now can be programmed to reduce roll while at anchor, also. This is a great boon to passengers who want to stay at a pretty anchorage but get queasy at night due to annoying rolling.

If you are prone to sea-sickness, be sure to select a cabin that is near the center of the vessel, thus minimizing the distance it moves in pitch, roll and yaw. This will be a cabin close to the waterline, and about equidistant from the bow and stern. Since lower down cabins are usually cheaper, you will save money, too.

Miscellaneous other tips for the seasick-prone: try to be well rested, fresh, and in good health when boarding; don’t fly and sail on the same day, since one motion sickness may compound the other; don’t drink alcohol before sailing or board when hung over; don’t eat a big greasy meal just before boarding; and avoid smells such as diesel fuel or bilge water. Avoid other persons who are seasick. When the vessel first encounters rough seas, go out on deck, move with the ship, enjoy the sea breeze on your face, and focus on the horizon. Look for other ships, birds, islands and clouds on the horizon. When you get tired, go directly to bed, lie down immediately and go to sleep right away.

As every sailor knows, there is one sure cure for seasickness: grab an oar and put it over your shoulder, march inland until someone asks you what is that odd thing you are carrying, then find a stone church, and sit with your back against its wall for four hours. Works every time!

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Lew Toulmin lives in Silver Spring, Maryland and has sailed on cruise ships and tall ships on every ocean.