Migraines have become more painful. What to do for severe vomiting?

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    I'm 47 years old, and for the last two years, my migraines have become progressively more painful.  The worst aspect of these recently more painful migraines are the severe vomiting.  I usually end up vomiting every hour from the morning thru to the night.  There is nothing that seems to work. There has been times where I have become so dehydrated and unable to eat or drink for a day or two. Any advice to make the vomiting less severe? My coworkers and my boss do not understand the pain and suffering I go thru. I work as a Pharmacy Tech, I know what to take and have all the preventative meds to take. Jan.

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    Dear Jan;


    The best way to stop the vomiting is to stop the Migraine with an abortive medication such as the triptans (Imitrex, Maxalt, Zomig, Amerge, Relpax, Axert, and Frova -- as well as Treximet, which is a combination of Imitrex and Naproxen Sodium) or ergotamines (DHE-45 and Migranal). For patients with severe vomiting, the nasal spray forms -- Imitrex, Zomig, or Migranal Nasal Spray -- or the injection forms -- DHE-45 or sumatriptan/Imitrex subcutaneous injections are often best.


    Some patients do require a medication to address the nausea at the beginning of the Migraine while waiting for the abortive medication to take effect. Which one is best depends on the patient. These medications include Reglan, Phenergan, and Zofran.


    There too many medications being used for Migraine prevention, more than 100 of them, for you to have tried them all. See Migraine preventive medications – too many options to give up! for more information.


    If your doctor isn’t able to help you, it may well be time to consult a Migraine and headache specialist. It’s important to note that neurologists aren’t necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.


    Good luck,
    John Claude Krusz and Teri Robert



    To review other questions from our Ask the Clinician Column,
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    If you need help finding a  Migraine and headache specialist,
     visit our listing of Patient Recommended Specialists.



    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and  Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and  Migraines. You can read more about Dr. Krusz or more about Teri Robert.


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    Last updated June 12, 2010.

Published On: June 16, 2010