Skip to Accessibility Tools Skip to Content Skip to Footer

Frequent Nausea Associated with Transformation to Chronic Migraine

Despite the frequency with which Migraine patients experience nausea during their attacks, we haven’t known much about how this common symptom might influence the progression of Migraine Disease from episodic to chronic.

At the 2013 International Headache Congress in June, researchers shared the results of a study examining this issue. They learned patients whose Migraine Disease transformed from episodic to chronic were likely to experience frequent, persistent nausea with their attacks.

Using existing data from the 2007 and 2008 American Migraine Prevalence and Prevention Study (AMPP), the research team identified two subgroups meeting certain criteria.

  • Patients with episodic Migraine and no or low frequency nausea.
  • Patients with episodic Migraine and persistent, frequent nausea.

They then looked at 2009 data from the AMPP study to identify patients that met the criteria for chronic Migraine (15 or more days of headache a month for the last three months) to draw conclusions about the relationship between the intensity of the nausea and transformation from episodic to chronic Migraine.

Among the 3,182 patients in the study:

  • 43.7% of episodic Migraineurs experienced persistent, frequent nausea.
  • 3.4% of episodic Migraineurs with persistent, frequent nausea transformed to chronic status.
  • 27.6% of episodic Migraineurs experienced no or low frequency nausea.
  • 1.5% of episodic Migraineurs with no or low frequency nausea transformed to chronic status.
  • Patients who experienced persistent, frequent nausea were fully twice as likely to develop chronic Migraine.

Even after the research team controlled for demographics (such as gender), migraine symptoms and headache-related disability, patients who experienced persistent, frequent nausea were twice as likely as those who experienced no or low frequency nausea to develop chronic Migraine.

Each time we learn more about the risk factors that may contribute to the transformation of Migraine from episodic to chronic, we increase the likelihood fewer patients will have to deal with that change in their lives. This is because we can address many of those risk factors, such as treating comorbid depression, for example. But even information about risk factors we cannot change or influence gives researchers important clues about the Migraine process.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

1. Michael L. Reed, Kristina M. Fanning, Daniel Serrano, Dawn C. Buse, Richard B. Lipton. "Persistent Frequent Nausea as a Predictor of Progression to Chronic Migraine: Results from the American Migraine Prevalence and Prevention (AMPP) Study." Headache, 55(1): 76-87, 2015.


  • art lover
    6 years ago

    I only have nausea once a migraine “gets going” and this time trying topamax I have been able to stay on it and it seems to be helping with the severity of the breakthrough headaches and as long as I take my phenergan, I usually don’t actually throw up. And it makes me blissfully sleepy which is fine. But I’ve had migraines since childhood and I’m fifty so it’s been a long time finding something that sorta works-the triptans and the topamax plus nausea meds. has anyone ever tried to wean off Excedrin or OTC drugs with caffeine? I need advice on that. I think that’s part of my problem too.

  • tucker
    6 years ago

    This is quite interesting. Back when my migraines were just here and there, I had severe headaches and some nausea and then the “daily headache” began. As it wore on and on, I finally went to the doctor and began preventive treatment, but as the years passed the daily nausea got ridicuously bad. Eventually, it, combined with some other medical problems caused me to lose about 40 lbs over 3-6 months just b/c I couldn’t eat. I’ve never gained that weight back in 3 years due to just a chronic lack of “hearty” appetite. I eat, sometimes a lot, but then get nauseated and feel awful afterwards.

    I’ve often said, I can stand the head pain if I could JUST get rid of the chronic nausea. I have more meds I try for chronic nausea and stomach “blech” than for the actual migraine itself it’s just that bad….

    And I totally agree with it being an assault on our senses. It’s like being pregnant for years on end. The smell of cooked broccoli is enough to make me gag, perfume, exhaust, the list goes on.

  • Dawn
    6 years ago


    I say the same thing… that as bad as the pain is, I could find a way to manage it if only I could find a way to live without the nausea. Best of luck to you! Dawn

  • jo hamilton
    6 years ago

    I’d like to comment about the assault our senses are subjected to during a attack. There have been times when I will wait till the last minute before going to the ER for meds, because the car ride, the motion, the bump, then the registering in, the wait is unbearable. I hear every conversation, sneeze, wrestling of paper, the harsh lights, the glare from the floors, etc. can be unbearable! I have found something to has given me back part of my self worth-volunteering in the NICU. The lights are dim, voices are low and the hospital lets me come on the days I feel good. And I believe that living with chronic pain has made this job of seeing such tiny babies in extreme conditions and talking to the new parents makes me relate and be compassionate when it comes to human suffering. Keep up the good work!

  • Poll