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Cholinergic agonists that do not cross into the brain such as neostigmine, do not produce motion sickness. Addiction to the patch can be managed by withdrawall, sometimes facilitated by use of oral agents containing hyocyamine. While the precise role of histamine in central vestibular processing is uncertain, there are data indicating that centrally acting antihistamines prevent motion sickness and reduce the severity of its symptoms even if taken after the onset of symptoms (Takeda et al, 1989).It is to be hoped that agents selective for vestibular subtypes of muscarinic receptors will eventually be developed or discovered among our presently available pharmacopoeia, as these agents may provide vestibular suppression with less side effects. This has been described for scopolamine (Luetje and Wooten 1996), and other anticholinergics may also have addiction syndromes. All the antihistamines in general use for control of vertigo also have anticholinergic activity.Oral versions of scopolamine would seem equally likely to work as patches (e.g.oral drugs for IBS) for motion sickness, but there currently is no oral version of scopolamine (hyoscine).There are also some reports of scopolamine inducing migraine, as well as a withdrawall syndrome.There is no reason to believe that any one nonselective ACH antagonist (e.g.A discussion of drug treatment should start with a discussion of the neurotransmitters used to signal in the vestibular system. Vestibular suppressant and antiemetic drugs are the mainstay of treatment of vertigo.

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Hyoscyamine, which is the L-isomer of atropine, is a common ingrediant in antispasmodic treatments for IBS.

Hyoscine, or scopolamine, is mainly used in the patch form to prevent motion sickness.

which affect muscarinic receptors, such as scopolamine, increase motion tolerance.

The action appears to be mainly central, although there are receptors in both the periphery and centrally.

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