Scopolamine patch

[netwayne]

Just got a prescription for this in hopes of avoiding my last boat dive experience. My question to those with experience with the patch is......if the patch is considered a 3 day deal but recommended to be applied 4 hours prior to the activity, if I have a 9AM dive tomorrow, do I really need to apply this at 5AM or can I do it the night before? Will I get the same or very similar benefit by applying it early?

Thanks!

 

[Gene_Hobbs]

The night before should be fine given the time release nature of the patch.

Some other info on Transdermal Scopolamine in case you are interested:

Transdermal Scopolamine in the Hyperbaric Environment.
Schwartz and Curley, 1986
RRR ID: 3528

Hyperbaric oxygen and scopolamine.
Bitterman et. al. 1991
RRR ID: 2573

Effects of transcutaneous scopolamine and depth on diver performance.
Williams et. al. 1988
RRR ID: 2495

all from the RRR suggested reading list.

 

[waaterpal]

Using this patch is the ONLY reason I can even get on a boat!! I put it on the night before. Clean and dry the skin well and place it on an area with no hair so it seals. The only time I ever had a problem during a dive I discovered that the patch was missing from my neck!

 

[netwayne]

Thanks for the posts! I am going to try putting it on tonight and see how I fare.....

 

[crab lover]

I always put it on the night before, that way if there are any of those nasty drowsy side effects, I can sleep them off first. Also, have a glass or two of water on the night stand, those patches will give you some hellacious dry mouth! Dry mouth, that means it's working!

 

[DocVikingo]

Hi Wayne,

All new medications should be given an adequate topside trial before diving to assess for worrisome side effects. A four hour trial arguably is inadequate for this purpose.

For Transderm Scop, a twelve hour topside trial would be more appropriate.

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[netwayne]

Well my trial ended up being putting the patch on the night before......roughly 12 hours before I stepped on the boat. I did eat a small breakfast just to have a little something in my stomach. Seas were similar to last time.....actually a lot rougher getting out of the inlet but about the same out in open water. Would estimate 2-4. I think the patch helped a bit but I still spewed during the SI between the 2 dives. Afterwards I was ok but not 100 percent and again was glad to get back to the dock. I'll keep trying different things to hopefully develop some better sea legs. The mate on the boat said she tried Bonine and the patch (as I have) and it was triptone that worked for her. Haven't tried that one yet. Eventually she was able to wean herself off of it. Probably not going to be able to do that as I am not on the boat all the time like she is. Thanks for your post. And by the way......only real side affects I noticed were a little drowsiness and dry mouth with the patch. I can deal with both of those if the med really works.

 

[DocVikingo]

Hi Wayne,

Sorry to hear that the patch wasn't the silver bullet, but at least you experienced some relief.

Before considering Triptone, which, like Dramamine Original Formula, is dimenhydrinate, I'd suggest that you read the following:


"The Psychometric and Cardiac Effects of Dimenhydrinate
in the Hyperbaric Environment

David McD. Taylor, M.D., Kevin S. O’Toole, M.D., Thomas E. Auble, Ph.D.,
Christopher M. Ryan, Ph.D., and David R. Sherman, R.N.

Study Objectives. To examine the psychometric and cardiac effects of
dimenhydrinate at 1 and 3 atmospheres (atm) of pressure (0 and 66 feet of
sea water, respectively), and to make recommendations about the drug’s
safety in the diving environment.

Design. Double-blind, placebo-controlled, crossover study.

Setting. Monoplace hyperbaric chamber of a university hospital.

Subjects. Thirty active divers (mean age 38 yrs).

Interventions. A bank of seven tests was used to assess cognitive function
during four different dive combinations: placebo-1 atm, placebo-3 atm,
dimenhydrinate-1 atm, and dimenhydrinate-3 atm.

Measurements and Main Results. Heart rate and cardiac rhythm were
recorded during all dives. Repeated-measures multivariate analysis of
variance was used to analyze the effects of dimenhydrinate, depth, and
drug-depth interaction. Dimenhydrinate resulted in a significant decrease
in scores of mental flexibility (trail-making, part B, p<0.05) but had no
effect on scores in the six other psychometric tests (p>0.05). It had no
effect on mean heart rate (p>0.05), although frequent unifocal ventricular
ectopic beats occurred in two subjects after ingestion of the drug. Depth
resulted in a significant decrease in verbal memory test scores (p=0.001)
and mean heart rate (p<0.001).

Conclusion. Dimenhydrinate adversely affects mental flexibility. This effect,
when added to the adverse effect of depth on memory, may contribute to
the dangers of diving.

(Pharmacotherapy 2000;20(9):1051–1054)"


While you've probably tried most of the remedies discussed the article I'm posting below, it's short and still might be worth a read. It's piece I wrote for Undercurrent (Scuba Diving for Serious Divers, Undercurrent Reviews Dive Resorts and Scuba Diving Equipment) a while back:

Tame the Technicolor Yodel: Managing Mal de Mer
Doc Vikingo's Sea Sickness Remedies

Regards,

DocVikingo

 

[stevephilanyc]

Hi Wayne-

You might try SOPACE (Motion Sickness - Prevent It and Enjoy Your Travel with Scopace), which is scopolamine in pill form. You can modify dosage (either one or two pills) based on what you're doing and I find it is easier on my system than the patch.

I really recommend it--it works great for me.

Steve

 

[DocVikingo]

Hi Steve,

Yes, and a detailed discussion of Scopace can be found the article linked in my post above, "Tame the Technicolor Yodel: Managing Mal de Mer."

Regards,

DocVikingo