Ounce of prevention. Pound of cure: Motion Sickness

#motionsickness #rollercoasters #themeparks #migraines #nausea #vomiting #disney #universal #roguemed #gorogue

A 40 year old healthy female contacted RogueMed regarding prevention of motion sickness prior to a trip to a theme park where she hoped to ride several roller coasters. She has a history of severe motion sickness that includes eventual severe migraines and vomiting. These episodes have been provoked by roller coasters, 3D movies, IMAX movies, and ocean voyages on small to medium sized craft. Other medical history includes multiple orthopedic injuries and surgeries, migraines for which she takes imitrex as needed, and an autoimmune disorder for which she takes Lialda. She has failed multiple motion sickness modalities notably scopalamine patches and dramamine makes her drowsy. She has previously tried Zofran 4 mg ODT after already feeling sick and she notes it was of minimal benefit. She agreed to try the regimen of Zofran 8 mg by mouth starting the day before the trip but asked to take it twice daily instead of three times daily with an option to take one mid day dose if she felt she needed it.

On debrief she noted that she did take the midday dose and each day had a moment in the afternoon after which she felt she was “done” but overall, she did not progress to fulminant motion sickness, migraine or vomiting and she felt she was able to enjoy her trip. She is planning a fishing trip in the future and would like to try the Zofran again.

Based on this experience and the experience of our Navy contractor, we predict that Zofran 8 mg by mouth every 8 hours starting the day before the trip or offending activity will prevent motion sickness in many susceptible people thus enabling them to fully enjoy their experience and remain productive. These are two case studies. A double blinded study with sufficient recruitment would be needed to make this powerful. We experimented with known indications for Zofran with the goal of preventing rather than treating motion sickness on a case by case basis.