Off-Vertical Axis Rotational Assessment of Transdermal Scopolamine for Motion Sickness Prophylaxis

Abstract The objectives of this study were to evaluate transdermal scopolamine for motion sickness prophylaxis, and to evaluate off-vertical axis rotation (OVAR) as a laboratory model of motion sickness. This was a randomized, prospective, double-blind study design, set in a vestibular research laboratory. The experimental subjects consisted of 12 patients – 7 male, 5 female – ages 21 to 57, with normal auditory/vestibular function. The intervention was off-vertical axis rotation 20 degrees in the dark after administration of transdermal scopolamine or placebo. The main outcome measures were time duration of tolerated off-vertical rotation, and subjective symptom reporting during rotation at one-minute intervals on a 0–4 scale. Results were as follows: patients treated with transdermal scopolamine had statistically significant improved tolerance time to off-vertical axis rotation. Reported symptom-atology on the 0–4 subjective symptom scale was significantly improved, as compared to placebo, and was dose-dependent. Conclusions are as follows: off-vertical axis rotation is a useful modality for the evaluation of motion sickness medications. Transdermal scopolamine showed statistically significant dose-dependent effects in mitigating OVAR-induced motion sickness symptomatology and was well tolerated.