Stimulation of the semicircular canals via the rotary chair as a means to test pharmacologic countermeasures for space motion sickness

• Published in: Otology & neurotology Vol. 25; no. 5; p. 740
• Main Authors: Dornhoffer, John, Chelonis, John J, Blake, Donna
• Format: Journal Article
• Language: English
• Published: United States 01.09.2004
• Subjects: Adolescent; Adult; Double-Blind Method; Female; GABA Modulators - pharmacology; GABA Modulators - therapeutic use; Histamine H1 Antagonists - pharmacology; Histamine H1 Antagonists - therapeutic use; Humans; Lorazepam - pharmacology; Lorazepam - therapeutic use; Male; Meclizine - pharmacology; Meclizine - therapeutic use; Muscarinic Antagonists - pharmacology; Muscarinic Antagonists - therapeutic use; Promethazine - pharmacology; Promethazine - therapeutic use; Scopolamine Hydrobromide - pharmacology; Scopolamine Hydrobromide - therapeutic use; Semicircular Canals - drug effects; Space Motion Sickness - drug therapy; Treatment Outcome; Vestibular Function Tests
• ISSN: 1531-7129; 1537-4505
• DOI: 10.1097/00129492-200409000-00016

Space motion sickness is currently treated pharmacologically with the empiric use of the H1 antihistamine promethazine, but use of this intervention is limited by the side effect of significant sedation. This creates a dilemma, as full cognition is particularly important during the same conditions likely to exacerbate the symptoms of space motion sickness. Using overstimulation of the semicircular canals with a rotary chair as a paradigm for space motion sickness, we evaluated four medications, commonly used for the treatment of terrestrial motion sickness and vertigo, for their efficacy in alleviating the simulated symptoms of space motion sickness. Randomized, prospective, double-blind study. Tertiary referral center. Healthy male and female volunteers, 18 years of age or older, without history of neurologic or psychiatric disorders, and with no known allergies or any previous adverse reactions to the drugs used. Lorazepam 1 mg, meclizine 25 mg, promethazine 25 mg, scopolamine 0.4 mg, or placebo. The ability of each treatment to control the nausea and vomiting associated with our paradigm for space motion sickness was evaluated by measuring time of rotation pre- and posttreatment and time of symptom onset pre-and posttreatment. Only scopolamine effected a mean change in duration of rotation that reached statistical significance when compared with placebo (p <0.008), with a greater than 40% increase in rotation time. Results with promethazine were not statistically significant. Results showed a rank order of efficacy of scopolamine > promethazine > placebo > meclizine > lorazepam. Scopolamine significantly increased rotation time, but none of the treatments resulted in a significant delay to onset of symptoms.