Scopolamine (hyoscine) for preventing and treating motion sickness

Area of Science:

• Pharmacology and Clinical Medicine
• Neuroscience and Vestibular System Function

Background:

• Motion sickness, characterized by nausea, vomiting, and headaches, arises from sensory conflict impacting balance organs.
• Existing management strategies include pharmacological, behavioral, and complementary therapies, with scopolamine (hyoscine) being a long-standing option.

Purpose of the Study:

• To systematically review the effectiveness of scopolamine for motion sickness prevention and treatment.
• To compare scopolamine against placebo, other drugs, behavioral, or complementary therapies in individuals without underlying neurological conditions.

Main Methods:

• A comprehensive search of multiple databases (Cochrane, MEDLINE, EMBASE, CINAHL) was conducted up to May 2007.
• Included were parallel-arm, randomized controlled trials (RCTs) evaluating scopolamine for motion sickness.
• Data extraction and quality assessment were performed independently, with pooled analysis using a random-effects model.

Main Results:

• Fourteen RCTs involving 1025 subjects met the inclusion criteria.
• Scopolamine demonstrated superior effectiveness compared to placebo in preventing motion sickness symptoms.
• Evidence suggests scopolamine may be superior to methscopolamine and equivalent to antihistamines for prevention, but data on other agents is limited; no studies addressed treatment of established symptoms.

Conclusions:

• Scopolamine is an effective agent for preventing motion sickness when compared to placebo.
• Comparative effectiveness against other medications like antihistamines and calcium channel blockers requires further investigation.
• Randomized controlled trials investigating scopolamine's therapeutic role in managing existing motion sickness symptoms are lacking.