Clinical Review

Managing motion sickness

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d7430 (Published 02 December 2011) Cite this as: BMJ 2011;343:d7430
  1. Louisa Murdin, academic clinical fellow in audiovestibular medicine1,
  2. John Golding, professor of applied psychology2,
  3. Adolfo Bronstein, professor of neuro-otology3
  1. 1Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK
  2. 2Department of Psychology, University of Westminster, London
  3. 3Centre for Neuroscience (Neuro-otology), Imperial College, London
  1. Correspondence to: L Murdin louisa{at}murdin.com
  • Accepted 14 November 2011

Summary points

  • Motion sickness is a common and potentially disabling problem, thought to be due to sensory conflict or “mismatch” involving the vestibular system

  • Management using behavioural methods such as habituation can be effective and has few adverse effects, but can be unpleasant and time consuming

  • Hyoscine is an effective preventive medication for which oral preparations and transdermal patches are established in clinical practice, and emerging evidence suggests that hyoscine nasal spray is effective in preventing motion sickness

  • Evidence to support the use of other drugs, taking into account the trade off between efficacy and adverse effects, is weaker.

  • Management of motion sickness with traditional remedies such as ginger and acupressure bands has not been shown to be effective.

Motion sickness is a syndrome of nausea and vomiting, pallor, sweating, headache, dizziness, malaise, increased salivation, apathy, drowsiness, belching, hyperventilation, and stomach awareness. Symptoms can be provoked by externally imposed motion, or implied self motion from a moving visual field, such as in a cinema. The condition has been recognised from the early days of sea travel and the word for sickness, “nausea,” derives from the Greek word νανς, meaning “ship.”

Travel by car, train, or other transport is part of everyday life for most people, and motion sickness is a common problem. Estimating its prevalence is complex because reported symptoms depend on variables such as previous avoidance and exposure, as well as presumed inherent susceptibility. Some estimates are presented in table 1. Motion sickness may have an important effect on occupational activity for some people, such as airline pilots, those in the armed forces, and emergency services staff. General practitioners may frequently encounter patients who report difficulties in work or daily life related to motion sickness, or those seeking advice about prevention before a forthcoming journey. We review the management …

Sign in

Free trial

Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
Sign up for a free trial

Subscribe