Hey, wanna be deep-sea fishermen and whale watchers? You know the type: you’d love to haul in a striper or gaze in awe at a pod of humpbacks—but you also know you’ll be chumming your breakfast over the side instead of a convenient bucket of fish guts.
Guess what? There's some good news! Maybe.
For the first time in 40 years, there's a new motion sickness drug, and it works pretty well, maybe even well enough that you'll get your sea legs.
First, time to reveal personal information
My wife doesn't merely get seasick in a boat. Noooooo, that's too pedestrian for her. She gets sick while snorkeling! In an enclosed cove. I'm still not sure about a mud puddle.
Seriously??? Snorkeling is one of my greatest passions, but our future vacations are more likely to be in some wretched art museum [2] than the Great Blue Hole in Belize or Black Rock in Maui.
Vacation discordance in the Bloom residence.
What's out there now for sea-sickness?
- Antihistamines
For decades, motion-sickness drugs have fallen into two familiar camps: Antihistamines and ear patches, which contain scopolamine (more on this below).
Older antihistamines like Dramamine (dimenhydrinate) and Bonine (meclizine) do help—sometimes. A 2022 Cochrane review found that in real-world travel settings, about 40% of people taking these drugs avoided symptoms, compared with 25% on placebo. That’s a real effect—but hardly anything to brag about (but perhaps, to barf about).
There are other downsides: the drugs must be taken about an hour before the "challenge," or forget it–once the nausea starts, you're toast. They can also cause drowsiness, which may be irrelevant if you're too busy blowing beets over the side.
It's safe to say that these drugs aren't especially good; perhaps one might say that they suck.
2. Scopolamine (transdermal)
Transdermal scopolamine patches, which require a prescription, work by blocking balance-related nerve signals (acetylcholine receptors) in the brain. These can be effective, but they bring along their own set of side effects, such as dry mouth and blurred vision. Which is better? Dunno. I was a bit surprised that I couldn't dig up any clinical trials that compare the two.
Although existing motion-sickness drugs kind of suck, it’s not surprising that drug companies haven’t gone after this target. Motion sickness isn’t fatal (even if you wish it were at the time), the market isn’t exactly scintillating, and the current drugs do work—to some extent.
Enter something new
That’s what makes the FDA approval of tradipitant (brand name NEREUS) notable.
Tradipitant is the first new motion-sickness drug in roughly 40 years and works differently from older options. Instead of dulling symptoms through sedation or anticholinergic effects—the latter being how drugs like the scopolamine patch work—it blocks neurokinin-1 (NK-1) receptors, shutting down a key brain pathway that triggers vomiting.
In two Phase 3 “real-world” boat studies, people with a history of motion sickness vomited far less often on tradipitant than on placebo—roughly 10–20% versus about 40%. That’s a large reduction by motion-sickness standards. Importantly, the benefit was strongest for vomiting, not mild nausea—a distinction that matters to anyone whose motion sickness reliably ends with their head over the side. [1]
Caveats
Tradipitant has not been tested head-to-head against scopolamine patches or antihistamines, so we don’t yet know how it compares directly with these established treatments. Does it work better than the old options? We won’t know unless it’s directly compared with them in a formal trial—an experiment I would cheerfully skip.
The approval is also based on single-dose, short-term use in provoked settings, meaning the drug was tested during brief, planned motion exposures. How well it performs during multi-day cruises or multiple trips remains unknown. And while the drug significantly reduced vomiting, many users still experienced nausea, underscoring that this is probably not the golden pot puke bucket at the end of the rainbow.
So… hi-ho or heave-ho?
Tradipitant won’t turn every landlubber into Jacques Cousteau. But for people whose motion sickness progresses from queasy to catastrophic—and who haven’t been helped much by antihistamines or patches—it represents a genuine, although probably modest advance.
After 40 years of treading water, motion-sickness treatment may finally be moving forward. Whether that’s enough to get my wife out of the museum and into Grace Bay remains to be seen.
NOTE:
[1] Antiemetic drugs, like Zofran, do not work against motion sickness.
[2] I may make fun of her, but my wife is an extremely talented artist. Her pastels are museum-worthy (IMO). Here's one of them.
Josh Bloom
Director of Chemical and Pharmaceutical Science
Dr. Josh Bloom, the Director of Chemical and Pharmaceutical Science, comes from the world of drug discovery, where he did research for more than 20 years. He holds a Ph.D. in chemistry.
