Merck Manual

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Motion Sickness

(Seasickness; Mal de Mer)


Adedamola A. Ogunniyi

, MD, Harbor-UCLA Medical Center

Reviewed/Revised Apr 2023

Motion sickness (also known as car, sea, train, or air sickness) involves a group of symptoms, particularly nausea, caused by movement during travel.

  • While traveling, people feel nauseated and dizzy and may break into a cold sweat and start hyperventilating.

  • Doctors base the diagnosis on symptoms and the situations in which they occur.

  • Ways to help prevent motion sickness include keeping the gaze and head as still as possible, getting some fresh air, not reading, not smoking or drinking alcoholic beverages before traveling, and sometimes taking a medication by mouth or skin patch.

  • Eating soda crackers or sipping ginger ale may help relieve the nausea, but once vomiting has started, a medication such as ondansetron or granisetron may be needed.

Motion sickness occurs when the parts of the inner ear that help control balance (including the semicircular canals) are overstimulated, as can occur when motion is excessive. It can also occur when the brain receives contradictory information from its motion sensors—the eyes, the semicircular canals, and the muscle sensors (nerve endings in muscles and joints that provide information about body position). For example, motion sickness commonly occurs during boat travel, when the boat rolls and rocks while the person looks at something that does not move, such as a wall. In this case, the rolling and rocking do not match the lack of movement in the wall.

The brain can also receive contradictory information if a person sees something moving excessively despite the person being still. This type of contradictory information may be received when, for example, a person watches a movie taken with a camera that shakes, or plays a video game. Motion sickness may also occur in a moving car or other vehicle or on playground or amusement park rides. Space travelers can also be affected.

Risk factors

Some people are more susceptible to motion sickness than others. Motion sickness is more common among women and children between 2 and 12 years of age, as well as in people who are susceptible to migraines, people who have labyrinthitis Purulent Labyrinthitis Purulent labyrinthitis is a bacterial infection of the inner ear that often causes deafness and loss of balance. The labyrinth is the bony cavity that contains the inner ear. The inner ear contains... read more (a disorder affecting the inner ear), or those who are pregnant or use hormonal contraceptives. Fear, anxiety, and poor ventilation increase the likelihood of experiencing motion sickness. Genetic factors may also increase susceptibility to motion sickness.

Symptoms of motion sickness sometimes lessen with age, and new-onset motion sickness is uncommon after age 50. Motion sickness is also rare in infants less than 2 years old.

Symptoms of Motion Sickness

Symptoms of motion sickness may begin relatively suddenly. Typical symptoms are nausea Nausea and Vomiting in Adults Nausea is an unpleasant feeling of needing to vomit. People also may feel dizziness, vague discomfort in the abdomen, and an unwillingness to eat. Vomiting is a forceful contraction of the stomach... read more , vomiting Nausea and Vomiting in Adults Nausea is an unpleasant feeling of needing to vomit. People also may feel dizziness, vague discomfort in the abdomen, and an unwillingness to eat. Vomiting is a forceful contraction of the stomach... read more , and a vague feeling of abdominal discomfort. Also, the face may become pale, and the person may break into a cold sweat. Dizziness, headache, and fatigue may develop, and the person may feel sleepy or be unable to concentrate. Other symptoms (often as a prelude to vomiting) may include increased saliva production, swallowing excessive air (aerophagia), and abnormally rapid, deep breathing (hyperventilation). Hyperventilation may cause faintness.

Nausea and vomiting make the person feel weak. Prolonged vomiting can lead to low blood pressure and dehydration. However, symptoms tend to gradually subside when the motion stops or the person leaves the vehicle. Also, people who are on long trips, as on a ship, usually adapt to the motion (helped by the stabilizers used in modern ships to minimize motion) and gradually recover.

Diagnosis of Motion Sickness

  • A doctor's evaluation

Motion sickness is diagnosed based on a description of the symptoms and the circumstances in which they occur.

Prevention and Treatment of Motion Sickness

  • Nonmedication prevention and treatment measures

  • Preventive medications (such as scopolamine and antihistamines)

  • Antivomiting medications (such as ondansetron or granisetron)

Measures to reduce the person's perception of motion include the following:

  • Keeping the eyes fixed on a distant object (for example, watching the horizon while on a boat)

  • Choosing a seat where motion is felt least (such as the front seat of a car, a seat over the wings in an airplane, or the forward/middle cabin or upper deck of a ship)

  • Keeping the head and body as still as possible

  • Sitting face forward and in a reclining position

  • Not reading

  • Sleeping

Measures to reduce the person's susceptibility to motion sickness include the following:

  • Getting fresh air by opening a window, opening an air vent, or going to a ship’s top deck

  • Not drinking alcoholic beverages (because it can aggravate nausea)

  • Eating small amounts of low-fat, bland, starchy foods instead of large meals, and not eating strong-smelling or strong-tasting foods

  • Avoiding food and drink on short airplane trips, especially on small airplanes

  • Possibly, not smoking

Before traveling, people who are susceptible to motion sickness can ask their doctor to recommend an over-the-counter medication or prescribe a medication to help prevent the disorder. People should take these medications before motion sickness starts because they tend to be less effective after symptoms begin. These medications include scopolamine (as a patch or as tablets), cyclizine, dimenhydrinate, diphenhydramine, meclizine, and promethazine (sometimes combined with caffeine). All of these medications can cause drowsiness. Because they may cause agitation in infants and very young children, these medications should not be given to them except under a doctor’s supervision. People performing activities that require alertness or concentration (including driving) should not take these medications. These medications also should not be taken with alcohol, sleep aids, sedatives, or other drugs that also cause drowsiness and decrease alertness.

If motion sickness develops, limiting food and drink to bland foods (such as soda crackers) and carbonated beverages (such as ginger ale) may help keep symptoms from worsening. If vomiting develops, an antivomiting medication, such as ondansetron or granisetron, can be given, sometimes by injection or as a skin patch.

Adaptation can be a particularly useful strategy for treating motion sickness. The more often a person is exposed to the stimulus that causes motion sickness, the less likely the stimulus is to cause a response. However, the reaction is specific to the stimulus, so a person who becomes accustomed to the motion of a large ship may still experience motion sickness in a small boat.

Some people try alternative therapies, such as wearing wristbands that apply acupressure or electrical stimulation or taking ginger Ginger Ginger is a flowering plant with a root (rhizome) that has long been used in cooking and in medicine and is thought to have antioxidant and anti-inflammatory effects. Antioxidants protect cells... read more (less than one gram), to prevent or treat motion sickness. Most of these therapies are unproven, but some people find them helpful.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Zofran, Zofran in Dextrose, Zofran ODT, Zofran Solution, Zuplenz
Granisol, Kytril, Sancuso, Sustol
Isopto Hyoscine, Maldemar, Scopace, Transderm Scop
Cyclivert, Marezine
Dramamine, Dramamine Motion Sickness Relief, Driminate, TripTone
Aid to Sleep, Alka-Seltzer Plus Allergy, Aller-G-Time , Altaryl, Banophen , Benadryl, Benadryl Allergy, Benadryl Allergy Children's , Benadryl Allergy Dye Free, Benadryl Allergy Kapgel, Benadryl Allergy Quick Dissolve, Benadryl Allergy Ultratab, Benadryl Children's Allergy, Benadryl Children's Allergy Fastmelt, Benadryl Children's Perfect Measure, Benadryl Itch Stopping, Ben-Tann , Children's Allergy, Compoz Nighttime Sleep Aid, Diphedryl , DIPHEN, Diphen AF , Diphenhist, DiphenMax , Dytan, ElixSure Allergy, Genahist , Geri-Dryl, Hydramine, Itch Relief , M-Dryl, Nighttime Sleep Aid, Nytol, PediaCare Children's Allergy, PediaCare Nighttime Cough, PediaClear Children's Cough, PHARBEDRYL, Q-Dryl, Quenalin , Siladryl Allergy, Silphen , Simply Sleep , Sleep Tabs, Sleepinal, Sominex, Sominex Maximum Strength, Theraflu Multi-Symptom Strip, Triaminic Allergy Thin Strip, Triaminic Cough and Runny Nose Strip, Tusstat, Unisom, Uni-Tann, Valu-Dryl , Vanamine PD, Vicks Qlearquil Nighttime Allergy Relief, Vicks ZzzQuil Nightime Sleep-Aid
Antivert, Bonine, Dramamine Less Drowsy, Dramamine-N, Medivert, Meni-D , Travel Sickness
Anergan-50, Pentazine , Phenadoz , Phenergan, Phenergan Fortis, Prometh Plain, Promethegan
Cafcit, NoDoz, Stay Awake, Vivarin
Dramamine Motion Sickness Relief, Dramamine-N
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