Scopolamine patch side effect and benefit by Ray Sahelian, M.D.
February 10 2016

A scopolamine patch behind the ear is used for seasickness.

Pharm Biol. 2016. Beneficial effects of ellagic acid against animal models of scopolamine- and diazepam-induced cognitive impairments. In a previous study, it has been shown that ellagic acid, a polyphenolic compound found in pomegranate and different berries, prevents cognitive and hippocampal long-term potentiation (LTP) impairments induced by traumatic brain injury in rats through antioxidant and anti-inflammatory mechanisms. This study demonstrates that ellagic acid is effective in preventing scopolamine- and diazepam-induced cognitive impairments without altering the animals' locomotion. This suggests the potential of EA application as a useful memory restorative agent in the treatment of dementia seen in elderly persons.

A transdermal scopolamine patch provides relief of postoperative nausea and vomiting (PONV). Neera Say, MD, assistant professor, department of anesthesiology, University of Pittsburgh Medical Center (UPMC), Pittsburgh, Pennsylvania, presented the findings on behalf of first author Vimala Ramesh, MD, and colleagues at UPMC. The researchers evaluated 85 patients undergoing cosmetic surgery who had at least 3 of 4 standard risk factors for PONV: female gender, history of PONV or motion sickness, current nonsmoker, and postoperative use of opioids. All patients underwent surgery under general anesthesia with intraoperative administration of ondansetron 4 mg as a preemptive antinausea agent. The researchers gathered postoperative data on vital signs, pain and nausea on a 10-point visual analog scale (VAS), presence of emesis, treatment for pain, nausea and vomiting, side effects of scopolamine such as dry mouth, visual changes, agitation, and sedation. Patients were randomly divided into 2 groups: 41 received a transdermal scopolamine patch 2 hours preoperatively, and 44 received a placebo patch at the same time. Nausea scores on VAS were collected hourly during postoperative hospital stay at about 3 hours and noted by the patient at 4-hour intervals following discharge. Nausea scores during hospital stay were modest (0.50 to 1.50) and not significantly different between groups. However, nausea scores were higher in the placebo group during the 24 hours after discharge from hospital. One patient in the scopolamine group and 3 in the placebo group had hospital admissions for uncontrollable nausea; there were 2 episodes of vomiting, both in the placebo group. Dry mouth was the most frequent adverse effect. The absence of a significant difference between groups might be a reflection of the intraoperative administration of ondansetron, the researchers suggested. Other physicians, however, suggested that an additional factor may be the timing of patch application -- 4 to 6 hours is required for the patch to achieve maximum effect.

Scopolamine patch and mariners, captains
Transdermal scopolamine is commonly used by mariners to prevent or treat seasickness. Most studies indicate that scopolamine administered transdermally via an adhesive patch does not impair performance of skills required to navigate a vessel.

J Clin Psychiatry. 2013. Pulsed intravenous administration of scopolamine produces rapid antidepressant effects and modest side effects.