For the millions who suffer from motion sickness, a new treatment has emerged: Nereus (tradipitant), the first FDA-approved drug for this condition in four decades. Motion sickness affects roughly one in three people worldwide, causing nausea, vomiting, dizziness, and other unpleasant symptoms during travel by car, train, plane, or boat. While usually harmless, the condition can be debilitating for those prone to it.
How Nereus Works
The drug operates by blocking a key chemical pathway in the brain that triggers vomiting. Motion sickness occurs when the brain receives conflicting signals from the eyes, inner ear, and body’s sense of movement. This mismatch activates substance P, a chemical messenger that stimulates vomiting through neurokinin-1 (NK-1) receptors. Tradipitant, an NK-1 antagonist, interrupts this process, effectively preventing the vomiting reflex.
The FDA approved Nereus based on clinical trials showing significant efficacy. In one study of nearly 400 participants, fewer than 20% of those taking tradipitant experienced vomiting compared to over 44% in the placebo group. Another trial found the drug prevented vomiting in 80–90% of participants, depending on the dosage (85mg or 170mg).
The medication should be taken orally, on an empty stomach, about an hour before anticipated motion sickness. The maximum recommended dosage is 170mg per day.
Comparing Nereus to Existing Treatments
Traditional motion sickness remedies include antihistamines like Dramamine and scopolamine patches. However, these often come with side effects such as drowsiness, dry mouth, and blurred vision. Nereus aims to avoid these drawbacks by targeting a more specific brain pathway, reducing unwanted side effects.
Other NK-1 antagonists are already used in medicine—maropitant for pets and aprepitant for post-surgical nausea in humans—suggesting a proven safety profile for this drug class. Clinical trials of Nereus reported mild side effects like sleepiness and fatigue, far less severe than those associated with older treatments.
Beyond Motion Sickness: Potential Applications
Vanda Pharmaceuticals, the drug’s manufacturer, is exploring additional uses for tradipitant. The company has completed studies suggesting the drug can reduce nausea and vomiting caused by GLP-1 drugs (used for obesity and diabetes treatment). These side effects are a major reason people discontinue these medications, making Nereus a potentially valuable adjunct therapy.
Non-Drug Approaches to Motion Sickness
While medication can be effective, several non-drug strategies can also provide relief:
- Minimize Sensory Conflict: Focus on a fixed point (like the horizon) to align visual input with inner ear sensations.
- Behavioral Techniques: Controlled breathing and relaxation can ease discomfort.
- Natural Remedies: Ginger candies may help settle the stomach.
- Acupressure Wristbands: Some find relief from these devices, which are thought to stimulate endorphin release.
The arrival of Nereus represents a significant step forward in motion sickness treatment, offering a new mechanism of action with potentially fewer side effects. Whether it proves superior to existing therapies remains to be seen, but it provides a fresh option for those who struggle with this common ailment.
