Scopolamine

background

Scopolamine (also called hyoscine) occurs naturally in belladonna plants, such as henbane (Hyoscyamus niger) and deadly nightshade (Atropa belladonna). Scopolamine is available as a prescription drug and has many effects in the body, including decreasing the secretion of stomach fluids, preventing nausea, slowing digestive action of the stomach and intestines, and dilating the pupils. Traditionally, belladonna preparations have been used as both poisons and remedies.
Scopolamine patches placed behind the ear, which deliver a relatively low dose at a constant rate over three days, provide a convenient delivery system with fewer side effects than scopolamine taken by mouth or injected. The most common adverse effects associated with scopolamine are dry mouth, dizziness, drowsiness, and blurred vision. A nasal spray has been tested, and eyedrops are in use.
Due to its effectiveness against seasickness, scopolamine is commonly used by sailors and scuba divers. The U.S. National Aeronautics and Space Administration (NASA) Reduced Gravity Office (RGO) uses scopolamine alone and in combination with dextroamphetamine to treat motion sickness symptoms during test flights.

Related Terms

Alkaloid, angel's trumpet, anisodamine, anisodine, Atropa belladonna, atropine, Barbidonna®, Barophen®, belladonna, belladonna drugs, Belladonnae folium, Belladonnae radix, Bellatal®, black henbane, bromhidrato de escopolamina (Spanish), burrachero (Spanish - Colombia), Buscopan®, corkwood tree, Datura inoxia, deadly nightshade, Donnagel®, Donnapectolin-PG®, Donnapine®, Donna-Sed®, Donnatal®, Donphen®, Duboisia myoporoides, Ficus septica Burm.f. (Moraceae), henbane, hydrobromide, hyoscine, hyoscine hydrobromide, hyoscyamine, Hyoscyamus, Hyoscyamus niger (henbane), Hyosophen®, ioscina bromidrato (Italian), Isopto® hyoscine, Kapectolin-PG®, Kinesed®, levo-duboisine, Malatal®, maldemar tablets, methylscopolamine, moonflower, Murocoll-2®, nightshade family, Polyalthia microtus Miq. (Annonaceae), Popowia odoardi Diels (Annonaceae), Scop®, Scopace®, scopace tablets, Scopine tropate®, scopolamine bromhydrate, scopolamine hydrobromide, scopolamine hydrobromidum, scopolamine ophthalmicops, Scopolia, Scopolia carniolica, Scopolia root, Scopoliae, Spaslin®, Spasmolin®, Spasmophen®, Spasquid®, Susano®, Transderm Scop® Patch, Transderm-V®.
Selected combination products: Twilight Sleep (morphine and scopolamine). Some older formulations of Percodan® and some European brands of methadone injectable fluid contain scopolamine hydrobromide.

evidence table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
 
Motion sickness (Grade: A)
There is sufficient evidence to support the use of scopolamine applied to the skin in preventing motion sickness.
Nausea (morphine-induced) (Grade: B)
When combined with morphine, scopolamine is useful for premedication for surgery or diagnostic procedures and was widely used in obstetrics in the past. The mixture also produces amnesia and a tranquilized state known as "twilight sleep."
Post-operative nausea / vomiting (Grade: B)
There is conflicting evidence from available research to support the use of scopolamine in the treatment of nausea after various surgeries.
Saliva production control (Grade: B)
Despite a limited number of properly organized studies, it seems that the use of scopolamine in the treatment of drooling has a sound physiological basis.
Abdominal pain (Grade: C)
Antispasmodic properties of scopolamine have been shown in preliminary research. Additional studies are needed.
ACE inhibitor-associated cough (Grade: C)
There is insufficient evidence to support the use of scopolamine in the management of cough induced by drugs that act as angiotensin-converting enzyme (ACE) inhibitors.
Addiction (Grade: C)
Scopolamine has been used in the past to treat addiction to drugs such as heroin and cocaine. Currently, there is insufficient evidence to recommend scopolamine as medication in this condition.
Airway obstruction (Grade: C)
In several small trials, scopolamine applied to the skin failed to affect pulmonary function and symptoms of reversible airway obstruction. Currently, there is insufficient evidence to support the use of scopolamine for this condition.
Alzheimer's disease (Grade: C)
There is not sufficient evidence to recommend scopolamine alone or in combination with tacrine for Alzheimer's disease. High-quality research in humans is required.
Anesthesia (prevention of dreams) (Grade: C)
Previous research suggests that intramuscular scopolamine prevents dreams or remembering dreams in healthy young women undergoing surgery with propofol-nitrous oxide anesthesia. More research is needed in this area.
Antidepressant (Grade: C)
Although scopolamine has been reported to have antidepressant effects, the evidence in this area is conflicting. High-quality research in humans is required.
Biliary colic (Grade: C)
There is insufficient evidence to support the use of scopolamine in the treatment of biliary colic (pain associated with inflammation of the gallbladder or gallstones).
Bowel disorders (Grade: C)
There is insufficient evidence to support the use of scopolamine for bowel conditions. More research is needed in this area.
Bronchial asthma (Grade: C)
There is insufficient evidence to support the use of scopolamine in the treatment of bronchial asthma. More research is needed in this area.
Death and dying (death rattle) (Grade: C)
Scopolamine is frequently given to patients dying in the hospice during the final 24 hours, although there is not high-quality clinical evidence supporting this use.
Dizziness (Grade: C)
Currently, there is insufficient evidence to support the use of scopolamine in the treatment of dizziness. High-quality research in humans is required.
Ear infection (children) (Grade: C)
There is insufficient evidence to support the use of scopolamine for the treatment of otitis media (ear infection) in children. More research is needed in this area.
Fainting (Grade: C)
Evidence to support the use of scopolamine for the prevention of fainting is lacking. Additional research is needed.
Headache (chronic) (Grade: C)
There is insufficient evidence to support the use of scopolamine in the treatment of recurrent throbbing headache. More research is needed in this area.
Heart attack (Grade: C)
There is insufficient evidence to recommend the routine use of a low dose of scopolamine for myocardial infarction (heart attack) patients. High-quality research in humans is required.
Heart failure (chronic) (Grade: C)
Currently, there is insufficient evidence to support the use of scopolamine in treating chronic heart failure. More research is needed in this area.
High blood pressure (Grade: C)
Currently, there is insufficient evidence to support the use of scopolamine in the treatment of high blood pressure. More research is needed.
Irregular heartbeat (Grade: C)
There is insufficient evidence to support the use of scopolamine in the routine treatment of an abnormally slow heartbeat. High-quality research in humans is required.
Irritable bowel syndrome (Grade: C)
There is conflicting preliminary evidence as to whether scopolamine is effective in the management of irritable bowel syndrome. More research is needed.
Labor and delivery (Grade: C)
Scopolamine shows promising results for use in labor and delivery. However, further studies are needed before conclusions can be made about its safety and effectiveness.
Kidney disorders (pain from kidney stones) (Grade: C)
Although several studies demonstrate that scopolamine affords significant pain relief for those with kidney stones, several other drugs appear to be superior to scopolamine. More high-quality research in humans is required.
Movement disorders (Grade: C)
There is insufficient scientific evidence supporting the effectiveness of scopolamine in treating people with involuntary movements caused by antipsychotic drugs. High-quality research in humans is required.
Peptic ulcer disease (Grade: C)
The results of several studies on the effectiveness of scopolamine in the treatment of peptic ulcer are conflicting. Currently, there is insufficient evidence to recommend the use of scopolamine as routine medication for this condition.
Poisoning (Grade: C)
Because scopolamine's ability to cross the blood-brain barrier is better than that of atropine, it has been suggested that it should be used in patients with organophosphate poisoning who have central nervous system symptoms. Further research is needed in this area.
Post-operative pain (Grade: C)
There is conflicting evidence concerning the use of scopolamine for the treatment of pain after laparoscopic sterilization or open prostatectomy. Further studies are needed in this area.
Preoperative sedation / anxiolysis (Grade: C)
Limited research suggests that scopolamine is able to relieve anxiety and cause sedation when used as a premedicant, although with less effectiveness than other drugs. Currently, there is insufficient evidence to support the use of scopolamine for this condition.
Seizures (Grade: C)
Currently, there is insufficient evidence to recommend the use of a scopolamine skin patch in the treatment of certain types of seizures. Additional research is needed in this area.
Urinary incontinence (Grade: C)
The results of a limited number of studies on the efficacy of a scopolamine skin patch in the treatment of overactive bladder are inconclusive. There is not sufficient evidence to recommend scopolamine as a medication for this condition.
Vomiting (cisplatin-induced) (Grade: C)
There is insufficient evidence from available studies to support the use of scopolamine in controlling vomiting induced by the anticancer drug cisplatin. More research is needed.
Gastroesophageal reflux disease (Grade: D)
Limited research suggests that scopolamine N-butyl bromide should not be used in the treatment of gastroesophageal reflux disease (GERD).