Article from Sailing Magazine
By: Rick Brucato
When it comes to preventing mal de mer,
natural and chemical options can offer relief
A stiff breeze pushes us up the lake,
along with some choppy water, as we set out on the season’s first cruise.
The fresh air feels great on this crisp morning and the crew is excited. The
chop, however, is building and an occasional steep roller lays us hard over.
We slog north and after taking it on the nose for two hours I notice one of
the crew starts looking a little pale. Seconds later, the guy is gripping
the lifeline, feeding the alewives and praying for salvation. We’re just
starting our five-day sail. What could have been done to prevent this and
what to do now? Can we salvage our sail?
Seasickness or mal de mer strikes even the most hardened sailor
occasionally. Seasickness occurs when the vestibular system, the balance
mechanisms within the inner ear, become disrupted and out of sync with
visual signals. The inner ear, consisting of the semicircular canal and
utricle, tracks a boat’s up and down and sideways motion. The brain
registers motion, but the visual system fails to provide confirming
information, and the mismatched messages can cause nausea. The most common
example is a boat’s rising and falling without an external reference point
such as horizon or fixed landmarks (or other boats in motion). If the body
is moving up and down, but vision is focused on something static, like the
cabin sole, nausea may ensue.
Many people are sensitive to motion alone, even without mismatched signals.
Factors that precipitate or exacerbate motion sickness include diet,
illness, dehydration, fatigue, negative associations from previous sailing
experiences (diesel exhaust or other fumes often become powerful triggers)
and anxiety. If car, airplane or roller coaster rides make you queasy,
sailing in rough weather may test your gut as well.
If seasickness threatens your sailing enjoyment, or hampers your crew, there
are effective countermeasures, including over-the-counter and prescription
drugs, non-drug therapies such as wristbands, dietary, health and
psychological strategies. Some approaches will work even when the misery has
already set in.
Prescription motion sickness medications fall into two classes:
anticholinergic and antihistamine. The most commonly prescribed seasickness
medication is Transderm Scop also called “the patch.” This round bandage,
worn behind the ear, contains the anticholinergic medicine scopolamine.
Scopolamine diffuses through a membrane at a constant rate, and is absorbed
through the skin, slipping in between vestibular system nerve cells, which
help regulate motion malaise. Blocking key signals at cholinergic nerve
junctions, scopolamine stomps out nausea pretty effectively. The patch must
be applied well ahead of time as effective blood levels are not achieved for
six to eight hours.
Scopolamine is also available in tablet form (Scopace), which has rated more
effective than the patch in some studies, possibly because dosing may be
more accurate. Scopolamine also comes in an injectable form, used for
mariners stuck in a life raft or rescue pod in offshore emergencies where
prolonged seasickness can become very dangerous. Because of its
anticholinergic properties, Scopolamine may cause dehydration, blurred
vision, short-term memory disruption and dry mouth and drowsiness. Your
physician must prescribe this powerful medication; make sure your doctor
knows what other medications you’re taking or if you have health problems.
In addition to scopolamine, the prescription drug Stugeron (brand name for
the drug cinnarizine) is often used in the United Kingdom and Germany, but
has not yet been approved in the United States. Stugeron is a prescription
antihistamine that inhibits stimulation of the vestibular system. It is
often included in studies that evaluate several drugs with scopolamine and
Antihistamines were not originally developed to aid sailors suffering from
seasickness. Ocean travelers suffering from allergies reported fewer
problems with motion sickness and nausea. Antihistamines also have intrinsic
anticholinergic properties, similar to scopolamine. Unfortunately,
antihistamines typically cause drowsiness.
Another prescription drug available in the U.S. is Phenergan (brand name for
the drug promethazine). Promethazine prevents vomiting and can serve as an
anti-motion sickness agent. It is also used as a sedative compound at high
doses. Promethazine has been used to treat astronauts—motion sickness in
space can be a serious problem.
Chlorpheniramine is another drug that has recently been tested in humans and
may become indicated for motion sickness.
In general, prescription drugs are stronger than the over-the-counter
remedies, and may conflict with other medications. The strength required for
motion sickness drugs varies with each individual. Sailors on a daysail have
different needs than those making transatlantic passages or offshore sailors
stuck in foul weather for several days.
Often, mild nausea or seasickness experienced on daysails or
coastal cruises can be prevented with nonprescription drugs or alternative
relief methods. The most recognized nonprescription drug, Dramamine, is
formulated with the antihistamine dimenhydrinate. This drug has helped many
green-gilled sailors, but it can leave the crew crawling for a bunk—this
antihistamine makes many sleepy. Dramamine and Bonine tablets now come in a
newer formulation, meclizine HCL. Meclizine HCL has fewer side effects,
including sleepiness. Bonine comes in chewable raspberry-flavored tablets.
Sedation caused by antihistamines has been prevented in tests by spiking the
compounds with nonprescription stimulants such as caffeine. Meclizine HCL
has been tested with caffeine in some studies. Scopolamine is available with
stronger, prescription stimulants as well. These combinations are used when
alertness and clear concentration are particularly important, as
antihistamines can interfere with concentration.
It is important to note that some medications may have side effects that may
make one more prone to seasickness or may reduce the effectiveness of
seasickness medications. Always remind your physician about your daily,
maintenance medications when requesting a medication for seasickness.
Sometimes a simple dose adjustment of your meds will reduce seasickness
Ginger comes in many forms but is most often sold either as Sailors Secret
or Anti-Nausea Ginger Gum, produced by the Sea-Band folks. Research studies
suggest ginger may speed up digestion, block nausea directly or otherwise
soothe a turbulent gut. The active constituents of ginger, polyphenolic
compounds or gingerols, inhibit Helicobacter pylori, a causal culprit in
dyspepsia, peptic ulcer and possibly colon and gastric cancer. Ginger root
extract (SGRE) has been combined with pycnogenol (a natural extract) into
Zinopin, a travel supplement that is supposed to reduce risk of deep vein
thrombosis (DVT) and motion sickness. Ginger does indeed seem to be good
Other herbal remedies include Sea-Sik Oral Spray, a mix of homeopathic and
herbal remedies; Queasy Pops, also from natural herbs that come in ginger,
peppermint and lavender flavors; and On The Move capsules, a combination of
ginger root, licorice root and cayenne. The effectiveness of the above
herbal remedies is not well documented, although Sea-Sik cites numerous
research studies on its Web site.
A natural remedy that has received attention is the herbal concentrate
Motion Eaze. Motion Eaze consists of oils from birch, frankincense, lavender
chamomile, and myrrh peppermint and ylang-ylang. Motion Eaze is dabbed
behind the ear, and probably absorbed into the vestibular system, much like
Acupressure relieves seasickness for some by stimulating or altering nerve
impulses at the wrist’s median nerve, which ultimately changes brain
chemistry associated with nausea. Sea Bands, BioBands and ReliefBands all
work on this principle. Sea Bands and BioBands exert pressure on the wrist
via a plastic bead. BioBands come with a Velcro strap that permits pressure
adjustment. ReliefBands apply an electrical shock to the wrist, blocking
impulses en route to the brain. ReliefBands are available as disposable
bracelets or with rechargeable butteries and a battery life indicator.
Multiple settings permit adjustment based on need, but they offer no relief
There is also some evidence that hypnosis reduces motion sickness. The
Journal of Clinical Pharmacology reported in 2000 that hypnosis was more
effective than promethazine in preventing sickness in laboratory testing.
A good diet
Any food or drink that is acidic or hard to digest such as orange
juice, coffee, fried bacon, sausage or eggs can cause stomach upset that may
precipitate more serious nausea and seasickness. Coffee also contains
caffeine, a diuretic that causes the body to eliminate water, even if water
Grease-ball breakfasts are better replaced with oat bran, granola, water or
less acidic juices and drinks. Sugary sodas may taste good, but in the heat
of a hot beat they can suck the water right out of you. Alcohol may take the
edge off, but too much increases the risk of serious seasickness for two
reasons. First, it impairs balance, equilibrium and can upset the stomach.
Secondly, alcohol is a major dehydrator; heat, wave motion and booze
cruising is a sure recipe for spiraling mal de mer. Sports drinks such as
Powerade, Gatorade and All Sport, help maintain electrolyte balance and
fluid control. Water, however, is still the best hydrator in many people’s
When seasickness tightens its grip, doctors and research studies indicate
lying on your side or back helps. This reduces head movements relative to
your body and also gives muscles a chance to relax, rather than fighting
seas and wind. Keeping an eye on the horizon may help too. When the chop
starts to churn, so does an upset stomach, and antacids such as Maalox or
Tums can help.
When medications, rest, sleep or prayer just can’t keep you from blowing
your bilge, it might seem a good idea to stop drinking or eating. However,
if misery spirals down drastically enough for dry heaves to kick in, you may
be en route to serious dehydration. Weakness from lack of calories may
complicate the situation. Try to keep hydrated with sports drinks or water,
even if you can only keep them down for a short while. Fluids are quickly
absorbed, as are liquid calories. Managing this cycle is very important to
feeling better. Energy bars, get into your system quickly and can really
Anxiety can bring on seasickness. How many times have we jumped on a boat
stressed to the max only to find that a challenging sail may actually put
our tired, stressed souls over the edge? Anxiety can make a person more
susceptible to seasickness, and worrying about hurling definitely makes it
Fear goes hand in hand with anxiety. Remember: If your spouse, child or
friend wants to sail, but has had bad experiences with seasickness, don’t
push them. Pick a couple of bluebird days to get them out, make sure they
have adequate seasickness protection, and let them know you’re willing to
run back to the dock should they start to feel poorly or scared. It is
definitely possible to reverse seasickness fear and anxiety, but you have to
be patient. Much of the battle is won by having confidence in the
medications and prevention steps.
There are many options and strategies to cope with seasickness. Several
effective prescription medications work well when tested ahead and taken at
the proper time. Nonprescription medications, alternative herbal
medications, ginger and wristbands all provide relief to some and can be
used together. Diet is important, avoiding alcohol, too much caffeine or
meals that are difficult to digest and greasy. Taken together, this
information should help take the misery out of sailing while seasick.