Sea Sickness Drugs ( Stugerone / Stunarone / Cinnarizine ) ... Use Caution

[Cruising Couple]

Hello Sailors: I suffer with sea-sickness and I was researching Stugeron as a possible rememdy, but no longer! Please read the letter below. This letter and other findings indicate this drug is known to cause acute and chronic parkinsonism. Thank you Dr. Verdery.


This is from the Latitude 38 letter and response about Stugeron.

Stugeron is a bad actor and should be used with real caution or not at all.


+++++++++++++++++++++++++++++++
April 2006


A LACK OF CRITICISM FOR THE BRAND NAME DRUG

I am writing in response to your comment about using StugeronT for
seasickness - and your annoyance that the Federal Drug Administration
doesn't approve it for sale in the United States.

I talked about medical preparations for cruising at the 2006
Zihuatanejo SailFest, and used that opportunity to review medications
for seasickness - including StugeronT, which is a brand name for
cinnarizine. Even though many people have found that cinnarizine is
effective in preventing seasickness without noticeable side-effects,
it is not a good drug. Cinnarizine is a 'sloppy' drug that interacts
with at least three different receptors in the brain and the rest of
the body, histamine and acetylcholine receptors like most drugs for
seasickness, along with dopamine receptors. In addition, it is a
calcium channel blocker. Incidentally, almost all adverse effects of
cinnarizine are found by looking for information under the generic
name. There is very little literature criticizing the brand name drug.

Low-dose cinnarizine, 25 mg, is sold in many countries as StugeronT
(among more than 40 brands) for vertigo and motion sickness.
Cinnarizine is banned - even in low doses - by airline pilots in the
United States because it impairs judgement. Higher dose cinnarizine,
75 mg, is sold as Stugeron ForteT in countries where it is available,
and is used to relax arteries due to its calcium channel blocking
effects. High doses have also been reported to unmask Parkinson's
disease, or make Parkinson's disease worse due to blocking dopamine
receptors. Drugs that have such different uses with such small
differences in dose are just not good drugs - even if they are
effective in some instances.

In these many regards, cinnarizine is similar to other medications
taken for nausea and seasickness - including PhenerganT and
CompazineT, which are available in the U.S. and have similar physical
and psychological side effects. In fact, all of the drugs for
seasickness - including original DramamineT, meclizine (non-drowsy
DramamineT), and Transderm-scopT - have many significant side-effects
and need to be used with caution, especially if someone is operating
complex and expensive equipment in situations where good judgment and
clear thinking are critical.

Cinnarizine is commonly sold in other countries as 25 mg tablets, but
it is usually effective at lower doses. Cinnarizine is not safe for
pregnant women, or children younger than five. People who have taken
cinnarizine, and who have found it to work without side-effects,
should take the lowest effective dose. But they should consult their
physician, especially if they have Parkinson's disease, take
medications for depression, or have heart disease. Higher dose 75 mg
tablets of cinnarizine, such as Stugeron ForteT, are aimed at a
different problem than seasickness.

Don't hold your breath waiting for the FDA to approve it for sale in
the United States.

Roy Verdery, M.D.
Jellybean, Pearson 36
Northern California / Santiago Bay, Mexico

Roy - We're not annoyed with the FDA, we're just confused as to why
the FDA and the drug approval agencies in many European countries
have come to such dramatically different conclusions about the wisdom
of using Stugeron. After all, if we're not mistaken, you can buy the
stuff over the counter in countries on the other side of the Atlantic.

Just for the record, we're going to remind everyone that it's very
foolish to take any drugs without consulting a physican - especially
as people get older and tend to take more medications.

[rebel heart]

I'm sticking with Bonine.

[goboatingnow]

its has and continues to be available over teh counter here in Europe, as the good doctor says all anti sea sickness drugs have side effects,but most sailors take such low doses over a short time ( maybe teh first day or two) that I really dont think its an issue,


Its also worth pointing out that all the studies have shown that people who exhibit Parkinson like effects, have recovered completely within 1-16 months after stopping. Its also worth noting that such effects are limited to relatively high dosages and continous use.

dave

[CarlF]

I'm not a doctor but think this piece seems unnecessarily alarmist. Pilots are restricted from many drugs that are considered quite safe for general use. Large doses of many common medicines can have bad side effects. I've never heard of anyone using the high dose Stugeron for seasickness. In the UK the 25mg pills are sold over the counter in a colorful little box right beside the equally colorful Bonine box. I feel just as safe with UK drug approval as US drug approval - especially one that has been marketed for over 50 years (the drug is manufactured and marketed by a subsidiary of the US pharmaceutical company Johnson and Johnson. First sold in 1955).

Stugeron is probably not marketed in the US not because of safety concerns but because the FDA approval process is very expensive. You need a huge potential market to justify the expense. J&J must have decided it wasn't worth it.

Sea sickness drugs effect people differently and you have to experiment. For me, Stugeron has the best results and by far the fewest side effects of the drugs - much less drowsiness than Bonine and neither the headaches or "hyper" feeling of Scopalamine. It is used by thousands of cruisers and generally considered the best sea sickness drug.

Having said that, I also depend also on non drug solutions - ginger, vitamin C, hydration, no alcohol, and staying on deck when not in my bunk.

Carl

[rebel heart]

Originally Posted by CarlF

I'm not a doctor but think this piece seems unnecessarily alarmist. Pilots are restricted from many drugs that are considered quite safe for general use. Large doses of many common medicines can have bad side effects. I've never heard of anyone using the high dose Stugeron for seasickness. In the UK the 25mg pills are sold over the counter in a colorful little box right beside the equally colorful Bonine box. I feel just as safe with UK drug approval as US drug approval - especially one that has been marketed for over 50 years (the drug is manufactured and marketed by a subsidiary of the US pharmaceutical company Johnson and Johnson. First sold in 1955).

Stugeron is probably not marketed in the US not because of safety concerns but because the FDA approval process is very expensive. You need a huge potential market to justify the expense. J&J must have decided it wasn't worth it.

Sea sickness drugs affect people differently and you have to experiment. For me, Stugeron has the best results and by far the fewest side effects of the drugs - much less drowsiness than Bonine and neither the headaches or "hyper" feeling of Scopalamine.

Having said that, I also depend also on non drug solutions - ginger, vitamin C, hydration, no alcohol, and staying on deck when not in my bunk.

Carl

Weird; I've never heard of Bonine making anyone drowsy. Not saying it isn't true; just never heard of it before.

[Cruising Couple]

Originally Posted by goboatingnow

its has and continues to be available over teh counter here in Europe, as the good doctor says all anti sea sickness drugs have side effects,but most sailors take such low doses over a short time ( maybe teh first day or two) that I really dont think its an issue,


Its also worth pointing out that all the studies have shown that people who exhibit Parkinson like effects, have recovered completely within 1-16 months after stopping. Its also worth noting that such effects are limited to relatively high dosages and continous use.

dave

Not to sound rude Dave, but you are correct:

It is worth pointing out that people had Parkinson-type effects for 16 months after taking this drug. I see the point you are trying to make, but IMHO not a risk worth taking. I conduct clinical research (pharmaceutical) trials in the U.S. If a drug is not approved as safe and effective in the U.S. there is a good reason.

I SUFFER with motion sickness and while it eases after day one, it is a terrible feeling. I've tried every approved medication listed on this forum and many other forums and I've also tried many anectodal home remedies. Ginger, hydration, empty stomach, avoiding alcohol, and staying above (best at the helm) all seem to work the best. And again .... after day one, I'm better. However, this doesn't help much for a couple who like to take day sails. LOL

Thank you all for sharing your remedies. And, for those who think different motions/movements (rolling, pitching, etc...) effect different people in a different way ... I agree.

Darby

[goboatingnow]

It is worth pointing out that people had Parkinson-type effects for 16 months after taking this drug. I see the point you are trying to make, but IMHO not a risk worth taking. I conduct clinical research (pharmaceutical) trials in the U.S. If a drug is not approved as safe and effective in the U.S. there is a good reason.

Well reading the clinical trials , the vast majority of test cases recovered in a short time, mainly a few very elderly took longer

As to US and safe, Its important to realise that cultural attitudes and bias as much informs such decision makers as hard facts. For example in Europe I can have a waiter serve my 14 year old a glass of wine, in the US I can not. Its doesn't mean wine is any more dangerous merely because the US limits it. European drug testing is on a par, if not more rigorous ( my brother is heavily involved in drug validation) then the US. It ultimately boils down to drugs administration views. Equally politics can and does enter it as well . ( foreign drug versus domestic etc)


The fact is the drug is on the market in Europe for many many years, more then enough to actually measure real side effects

Dave

[colemj]

I'm not arguing the content posted above, but I am arguing your alarmist claim that this drug CAUSES Parkinson's disease.

That claim was only made by you and not the information you referenced. That information said that (undefined) high doses unmasked the disease and made symptoms worse.

That is not the same as, or even close to, causing the disease. If it did cause the disease, it would be under intense mechanistic study because nobody currently understands the cause of the disease.

Mark

[zeehag]

ALL antiseasick drugs cause drowsiness in humans. try ginger and try those wrist bands-- they work for many, and without drowsiness.

[bobconnie]

Now I heard, (not from personal knowage) that in Canada, Doctors perscribe Pot for sea sickness? at least thats what a couple of Canadians told us ! anybody know if this is true ?? just wonderd us old guys wonder about a lot LOL Bob and Connie

[Cruising Couple]

Originally Posted by colemj

I'm not arguing the content posted above, but I am arguing your alarmist claim that this drug CAUSES Parkinson's disease.

That claim was only made by you and not the information you referenced. That information said that (undefined) high doses unmasked the disease and made symptoms worse.

That is not the same as, or even close to, causing the disease. If it did cause the disease, it would be under intense mechanistic study because nobody currently understands the cause of the disease.

Mark

Mark ..... please read again. At no time did I say Stugerone (cinnarizine) causes Parkinson's disease. What I said is that it causes Parkinson-type symptoms and that has been confirmed by others in this link. Here is one easy read on the subject and there are other professional publications as well. Finally, it is not my place to tell anyone what they should take or not, I simply said "use caution."

Cinnarizine - Tardive Dyskinesia Causes

No on appreciates being misquoted.

Darby

[Cruising Couple]

Originally Posted by colemj

I'm not arguing the content posted above, but I am arguing your alarmist claim that this drug CAUSES Parkinson's disease.

That claim was only made by you and not the information you referenced. That information said that (undefined) high doses unmasked the disease and made symptoms worse.

That is not the same as, or even close to, causing the disease. If it did cause the disease, it would be under intense mechanistic study because nobody currently understands the cause of the disease.

Mark

One more for Mark and any others who may be interested:

Cinnarizine-induced parkinsonism: Ten years later - Mart[]-Mass[] - 2004 - Movement Disorders - Wiley Online Library

Furthermore, parkinsonism and Parkinson-like symptoms or Tarkive Dyskinesia (TD) are NOT Parkinson's disease. The former resemble the later and may or may not be indicative of the disease.

Thank you,
Darby

[colemj]

Originally Posted by Cruising Couple

Mark ..... please read again. At no time did I say Stugerone (cinnarizine) causes Parkinson's disease. What I said is that it causes Parkinson-type symptoms and that has been confirmed by others in this link. Here is one easy read on the subject and there are other professional publications as well. Finally, it is not my place to tell anyone what they should take or not, I simply said "use caution."

Cinnarizine - Tardive Dyskinesia Causes

No on appreciates being misquoted.

Darby

"this drug is known to cause acute and chronic parkinsonism"

Yes, you are correct. I apologize. I missed the "ism" at the end. I'm not arguing your thesis at all, I was just arguing parkinsons, which I misread into your parkinsonism.

Mark

[boatman61]

Originally Posted by bobconnie

Now I heard, (not from personal knowage) that in Canada, Doctors perscribe Pot for sea sickness? at least thats what a couple of Canadians told us ! anybody know if this is true ?? just wonderd us old guys wonder about a lot LOL Bob and Connie

Some folk suffer side effects... they throw up....

[Cruising Couple]

Originally Posted by colemj

"this drug is known to cause acute and chronic parkinsonism"

Yes, you are correct. I apologize. I missed the "ism" at the end. I'm not arguing your thesis at all, I was just arguing parkinsons, which I misread into your parkinsonism.

Mark

Thanks Mark .... Here's wishing you safe and healthy sailing!

Darby