Advances In Motion Sickness In Adults
- devillamcn
- 10 hours ago
- 4 min read
Motion sickness is a common condition that occurs when the brain receives conflicting signals about movement from the body’s sensory systems. It can be triggered by traveling in a car, boat, or airplane, as well as by virtual reality or other simulated environments. Common symptoms include nausea, vomiting, dizziness, headache, and fatigue. The severity of these symptoms varies among individuals based on their sensitivity and susceptibility to motion. Although motion sickness is generally not considered dangerous, it can significantly affect comfort, travel experiences, and overall quality of life.
Etiology of motion sickness
The sensory conflict and neural mismatch theory explains motion sickness as a result of conflicting signals received by the brain from the inner ear, eyes, and body. These sensory signals are transmitted to the vestibular nuclei in the brainstem, where they are integrated and compared. The information is then relayed to other areas of the brain involved in movement, balance, and autonomic functions. When the incoming sensory information does not match the brain’s expected patterns of movement, it can trigger pathways that produce autonomic symptoms, such as nausea, sweating, and vomiting. Current management primarily focuses on preventing symptoms through behavioral measures and medications, although existing treatments may be limited by side effects and variable effectiveness.
Pharmacologic therapies for treating motion sickness
Current therapies for motion sickness are intended to prevent symptoms before they occur rather than treat established nausea and vomiting. Common medications include:
Scopolamine - a prescription transdermal patch applied behind the ear 4-12 hours before travel. It provides protection against motion sickness for up to 72 hours, and is often preferred for cruises and long travel. Although the patch provides long-lasting protection, its anticholinergic side effects, such as dry mouth, drowsiness, and dizziness, can limit its tolerability for the user.
Meclizine - an over-the-counter drug that is taken about one hour before travel. It has antihistamine and anticholinergic properties, which can prevent motion sickness for up to 24 hours and treat vertigo by calming the parts of the brain and inner ear that control balance. This drug is a common choice for car or air travel.
Dimenhydrinate (Dramamine) - an over-the-counter antihistamine that is taken 30 to 60 minutes before travel, with repeated dosing every 4 to 6 hours. Like meclizine, it calms the signals that control the brain, inner ear, and balance. It is highly effective for moderate to severe symptoms, but often causes drowsiness and other side effects such as dry mouth and blurred vision.
Promethazine - a prescription antihistamine that is taken 30 to 60 minutes before travel. It is highly effective but highly sedating, and more commonly reserved for severe symptoms.
Non-pharmacologic alternatives
Behavioral and environmental approaches can reduce the severity of symptoms and can be effective in preventing motion sickness:
Avoid heavy meals and ingesting large volumes of liquid before travel
Limit the ingestion of caffeine, alcohol, and foods high in histamine content (cheese, tuna, salami)
Sit where the motion of the head and the body is least pronounced (front seat of the car, wings of an airplane, midship of the boat)
Stay well rested and well hydrated during travel
Minimize reading and screen use during travel
Look at the horizon or in the direction of travel to reduce the sensory mismatch that causes motion sickness
Repeated, incremental exposure (habituation) to motion stimuli can reduce susceptibility in some individuals
New FDA-approved motion sickness medication for adults
In December 2025, the USA Food and Drug Administration approved Nereus™ (tradipitant) for the prevention of vomiting caused by motion sickness in adults. It is the first new prescription medication approved for motion sickness in over 40 years. Nereus™ is an oral neurokinin-1 (NK-1) receptor antagonist that offers a novel treatment option distinct from commonly used antihistamine and anticholinergic medications. It works by blocking the action of substance P, a neurotransmitter involved in triggering nausea and vomiting. The recommended dose is 85 mg or 175 mg, taken on an empty stomach or 60 minutes before travel. The drug was tested in two phase 3 clinical trials involving 681 participants aged 18 to 75 years with a history of motion sickness during travel. The results concluded that people taking Nereus™ had significantly fewer episodes of vomiting compared to those taking placebo. The most commonly reported side effects of the drug included sleepiness, headache, and fatigue, which were generally mild after taking a single dose of the drug. Therefore, Nereus™ may be particularly helpful for patients who do not tolerate or respond adequately to existing therapies while taking into account the drug’s mild side effects.
Conclusion
The overall management of motion sickness in adults continues to rely on preventative strategies, with existing treatments tailored to the duration of travel, severity of symptoms, and patient characteristics. Common medications, including scopolamine and antihistamines, can be effective but have side effects such as drowsiness and dry mouth. Behavioral and environmental modifications can be combined with these drugs in reducing the severity of motion sickness, particularly in individuals with mild to moderate symptoms. The introduction of the NK-1 receptor antagonist Nereus™ (tradipitant) marks a significant milestone as the first new prescription therapy approved for motion sickness in more than 40 years, providing a novel therapeutic option for patients who do not respond to or cannot tolerate existing treatments. As the understanding of motion sickness pathophysiology continues to evolve, future therapies may offer more targeted symptom control with improved tolerability and greater patient convenience.
References
Leung, A. K., & Hon, K. L. (2019). Motion sickness: an overview. Drugs in context, 8, 2019-9-4. https://doi.org/10.7573/dic.2019-9-4
Takov V, Tadi P. Motion Sickness. [Updated 2023 Jul 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK539706/
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