Dramamine and Diving?

[jenmichigan]

I recently read an article in the Detroit News about dramamine and diving. It said "Dramamine could have a serious effect on a diver’s mental functioning and judgment"

Has anyone ever heard of this or had any experiences with dramamine?

This is the link to that article:
http://detnews.com/2000/health/0912/scuba/scuba.htm

Please reply with any information
Thank You,
Jennifer
http://www.MichiganShipwrecks.com

 

[BillP]

Hi Jennifer:

Please excuse me while I rant for a minute, then I'll see if I can get around to answering your question. Any drug that you take hoping that it will have an effect, can also have a side effect, regardless of whether it's by prescription, over-the-counter (OTC), or "all natural". You should always know exactly what you're taking when you take a drug, and you should also have a pretty darn good idea what it's supposed to do for you and what it can do to you. How many divers do you think really know what they're talking about when they say "Dramamine" or "Sudafed"? Did you know that there are four different types of "Dramamine" and no less than fifteen different kinds of "Sudafed"? OTC drug manufacturers understand the marketing benefits of brand name identification and loyalty, and they use it to their advantage. They often market products that are totally different (chemically) under the same or similar name. It's up to you to know what you're taking. (Rant mode mostly off.)

I'm aware of the study that you mention. It looked at original "Dramamine" which has the generic name dimenhydrinate. When I saw the study showing that dimenhydrinate can have adverse effects in divers, I told myself, "Well, duh!" Dimenhydrinate is an antihistamine that is closely related to diphenhydramine (e.g. Benadryl). One of the problems with the "older" antihistamines is that they can cause drowsiness. If you read the product information literature for Dramamine (dimenhydrinate) it states, "May cause marked drowsiness". Hmmm, if you happen to be one of the people who gets markedly drowsy with the medication, don't you think that it might affect your ability to dive? I guess that it's a good thing that someone actually went out and got the funding to do the study, but it seemed like a no-brainer to me.

The maker of Dramamine (Pharmacia and Upjohn) also makes a product that they call "Dramamine Less Drowsy Formula". This has also been known as "Dramamine II". The generic name for Dramamine Less Drowsy Formula is meclizine (the same active ingredient in Bonine) and is very different than dimenhydrinate. It is also an antihistamine, and can cause drowsiness (they do call it "Less Drowsy" and not "Non-Drowsy") but somewhat less drowsiness than the original Dramamine for most people.

The best medicine for seasickness is no medicine at all, if you can get by without it. But if you're like me and prone to seasickness, you need to weigh the effects of the seasickness against the potential side effects of any seasickness treatment. The goal is to come up with an effective treatment that has the fewest (or at least an acceptable level of) side effects. What treatment works best is different for different people. We each need to figure out what works best for us.

HTH,

Bill

 

[ScubaBaby]

I have actually taken Dramamine when I was diving in the Red Sea.
I suffered badly the first dive and took it for the rest of the holiday (when on the boat or walking round covered with a towel!)
Anyway, I found I was missing half of the briefings due to the fact that I was sooo sleepy the whole time. This was the cause of Dramamine but I couldnt cope with an hour journey without it - I was seriously green in the face.
It was quite choppy which is why I probably relied on Dramamine but is there any other alternative?
The Dramamine did make me very sleepy when I was on the boat but as soon as my head was underwater I've never felt so alive - I guess its cause I was paying so much attention to what was around me.
Anyway, is there any other alternative to Dramamine - that wont make me feel sleepy???

Is there anyone on this board that gets seasick but can cope with live-a-boards???? I am suppose to be doing a live-a-board in August to the south red-sea and am a tad concerned my stomach couldnt take it!

 

[BillP]

Hi Abby:

When you say that you took "Dramamine" that could mean that you took either dimenhydrinate or meclizine depending on which formulation of "Dramamine" you took. The original Dramamine (dimenhydrinate) is the Dramamine in the article Jennifer mentioned that causes such significant drowsiness. It causes so much drowsiness for some people that makers of Dramamine came out with Dramamine Less Drowsy (meclizine) that, well, causes less drowsiness. Which were you taking?

There are lots of alternatives to original Dramamine (dimenhydrinate) and Dramamine Less Drowsy (meclizine). The best medicine is no medicine at all. Often if people keep to the middle of the boat, away from exhaust and food fumes, and stare at the horizon the seasickness will pass. (But this can get pretty old on a week-long liveaboard trip.)

Your system will eventually acclimate to the pitching and rolling, but maybe you can give it a headstart. Go to the local gym and spend time every day on the trampoline before your trip, or go to the park and swing for an hour or so a day. Take up ballet. Ballerinas get to where they can spin and not get sick at all. Even playing a "first person shooter" computer game like Doom can help get your brain used to the confusing disorientation effects of eye vs. inner ear that causes seasickness.

Avoid things that contribute to seasickness. Please do eat (an empty stomach can make seasickness worse) but avoid fried/greasy foods, foods you find slow to digest, or "acid" foods. Skip the alcohol. Drink plenty of water so you don't get dehydrated. Stay away from other people who are seasick. (It's contagious! ;-)

After you've tried the above, you might try home remedies. Ginger tea or even gingersnaps will help some people. Peppermint helps others. Some people swear by the "Seabands" acupressure wrist bands. ( http://www.mellenmedical.com/seaband.htm )

The next line of defense against seasickness are the over-the-counter medications. Dimenhydrinate (original Dramanine, Triptone) is effective for many, but also causes drowsiness for many. Meclizine (Dramamine Less Drowsy, Bonine, Antivert) is more effective than dimenhydrinate and less sedating. Diphenhydramine (Benedryl) is effective, but more sedating than dimenhydrinate.

Next, you move up to prescription meds. The prescription medication of choice for most people for seasickess (according to DAN and the US Navy) is Transderm-Scop, the scopolamine patches. They can have significant side effects in some people. In the UK you have the prescription med cinnarizine (Sturgeron) available that seems safe and effective for seasickness (not available in the US). There are other prescription meds too. Drugs in the phenothiazine family like promethizine (eg Phenergan) are effective, but very sedating. Newer prescription nausea medicines like Ondansetron (Zofran) and Dolasetron (Anzemet) are effective at relieving the nausea from chemotherapy and surgery, but their effectiveness for seasickness is yet to be determined.

Is there any alternative to Dramamine? Sure, lots. Will they make you sleepy? Maybe, try them before your next trip and see. (Anything you try taking for seasickness should be tried before your trip to see how it affects you. Seasickness medications are also safer and more effective if you start them before you get on the boat.) You have plenty of things you can try so you can find out what works best for you.

HTH,

Bill

 

[RC]

I love you guys, you have no idea of how happy I am to find out that I'm not the only one who "feeds the fishes every now and then. I also let my buddy know if I've taken anything just as a precaution.

 

[ScubaBaby]

RC - when you do "feed the fish" they tend to crowd you something cronic dont they!

Your not the only one!!! Trust me.

I agree that you should always tell the person your diving with if your taking anything - whether it be for seasickness or anything else as if there was a problem then you'd want someone to know to tell lifeguards etc.

 

[scubadoc]

There are a couple of things that I might add to Dr. BillP's great letters.

Here is the reference to the studies if interested.
The Psychometric and Cardiac Effects of Pseudoephedrine and Dimenhydrinate in the Hyperbaric Environment,
Taylor et al, Pharmacotherapy 2000:20;(9):1045-1054
These two original articles report nicely designed studies showing that there are few significant dangers to using
Pseudoephedrine (Sudafed) in a hyperbaric chamber but that the sedative effects of Dimenhydrinate (Dramamine) are potentiated (by depth) and cause significant decrease in cognitive function.

Both of the studies are well done and the information that they yield corroborate what has generally been deduced by the diving medical community - that is, that pseudoephedrine has no inherent dangers in compressed air diving and that dimenhydrinate causes drowsiness that is potentiated by the effects of nitrogen at depth.

The study is flawed in that it was done in a dry chamber and does not take into account the effects of immersion and hydrostatic pressure. In addition, as stated by the authors, the test was done on highly intelligent divers with a large amount of cognitive brain reserve. (Using only 'half a brain, with one arm tied behind' - so to speak.

The other item is about Meclizine, or the 'less drowsy' "Dramamine". Meclizine is an effective drug for motion sickness but has similar anti-cholinergic effects (effects similar to scopolamine and atropine) and therefore should not be used together with the Trans-Derm Scop patch. Most observers find that the patch is the most effective sea sickness remedy.