A comparison of cinnarizine and transdermal scopolamine for the prevention of seasickness in naval crew: a double-blind, randomized, crossover study.

OBJECTIVES: The objective of the study was to compare the efficacy of transdermal scopolamine and cinnarizine in the prevention of seasickness and their adverse reactions.

METHODS: Seventy-six naval crew members participated in a double-blind, randomized, crossover study. On 2 voyages, they were administered either a transdermal scopolamine patch containing 1.5 mg scopolamine and placebo tablets or 25-mg cinnarizine tablets and a placebo patch. Subjects completed questionnaires for each voyage, reporting on the efficacy of the drugs, the severity of their adverse reactions, and the preferred treatment.

RESULTS: Subjects reported the scopolamine patch to be significantly more effective than the cinnarizine tablet (P = 0.029). A moderate to high degree of drowsiness was attributed more frequently to cinnarizine than to the scopolamine patch (34% and 17%, respectively; P < 0.02). Any adverse reaction, to at least a moderate degree, was more frequent with cinnarizine (38%) than with the scopolamine patch (22%), although the significance of this association was borderline. A significantly greater percentage of subjects preferred transdermal scopolamine to cinnarizine (41 vs 12%, P < 0.001).

CONCLUSIONS: Higher efficacy, a lower rate of adverse reactions, and convenience all led the participants of this study to prefer the scopolamine patch to cinnarizine. Considering the 2 therapeutic options assessed in this study, and in light of the findings of previous studies, it is recommended that the scopolamine patch be used as the drug of choice for the treatment of seasickness among naval crew in particular and probably also among all other sea travelers.