Nausea in migraine
Pro Research Analysisby 
Searched over 200M research papers
Nausea in Migraine: Understanding and Managing a Common Symptom
Introduction to Migraine-Associated Nausea
Nausea is a prevalent and debilitating symptom experienced by individuals suffering from migraines. It often accompanies other migraine symptoms such as headache, vomiting, and sensitivity to light and sound. Understanding the origins, frequency, and management of nausea in migraine patients is crucial for improving their quality of life.
Origins of Nausea in Migraine
Research indicates that nausea in migraines can occur independently of pain and trigeminal activation. A PET study revealed that during the premonitory phase of nitroglycerin-induced migraines, patients experiencing nausea showed activation in the rostral dorsal medulla and periaqueductal grey (PAG) areas of the brain. These regions include the nucleus tractus solitarius, dorsal motor nucleus of the vagus nerve, and the nucleus ambiguus, which are all involved in mediating nausea .
Frequency and Burden of Nausea in Migraine
Nausea is a defining feature of migraines, affecting a significant portion of migraineurs. Surveys and studies have shown that nausea occurs in more than 90% of migraine sufferers, with nearly one-third experiencing it during every attack . Persistent frequent nausea (PFN) has been identified as a predictor of progression from episodic migraine (EM) to chronic migraine (CM) . The presence of nausea can also interfere with the ability to take oral migraine medications, further complicating treatment 58.
Management of Migraine-Associated Nausea
Acupressure
One effective non-pharmacological approach to managing migraine-associated nausea is acupressure. A study on the application of pressure to the PC6 acupoint using a Sea-Band® wristband demonstrated significant reductions in nausea intensity during migraine attacks. Patients reported lower nausea scores and a higher consistency of treatment response when using the wristband .
Pharmacological Treatments
For patients whose nausea is not controlled by conventional antiemetic therapy, antimigraine medications such as amitriptyline have shown promise. In cases where nausea and vomiting are prominent features of migraine, a therapeutic trial of prophylaxis may be indicated . Additionally, the use of calcitonin gene-related peptide (CGRP) inhibitors has been associated with nausea, although the risk varies between CGRP receptor antagonists and anti-CGRP antibodies .
Conclusion
Nausea is a common and significant symptom of migraines, impacting the daily lives and treatment efficacy for many sufferers. Understanding its origins, frequency, and effective management strategies, including both acupressure and pharmacological treatments, is essential for improving patient outcomes. Further research and awareness are needed to ensure that nausea and other gastrointestinal symptoms are adequately addressed in migraine management.
Sources and full results
Most relevant research papers on this topic