Managing Migraine Nausea

Nausea and vomiting are as (or more) disabling than pain for some people with migraine. Not only do these symptoms add to the misery of migraine, migraine medications aren't very useful if you can’t keep them down. Fortunately, there are effective ways to manage nausea. Most of the options don’t interact with each other, so you can use multiple approaches at once.

Medication: Prescription drugs called antiemetics treat nausea and vomiting. The most commonly prescribed for migraine are ondansetron (Zofran), proclorperazine (Compazine), promethazine (Phenergan), and metoclopramide (Reglan), though there are many different kinds available. These drugs can be taken orally or, if you have trouble keeping anything down, as a tablet or film that dissolves under the tongue, a suppository, an injection, or a patch. If you’re at your doctor’s office or in an infusion clinic, they can also be given as a shot or through an IV. You may need to try a few different drugs and delivery methods before finding the one that works best for you. Sleepiness is the primary side effect, which you may find welcoming during a migraine attack.

Ginger: Available as fresh or dried teas, drinks, candies, oils and capsules, ginger has a strong track record for reducing nausea and vomiting.¹ It can also increase gastric emptying, which is helpful if gastroparesis is one of your migraine symptoms. Check your health food store for a preparation you prefer. Fresh ginger is my go-to for nausea. It keeps well in the freezer whole (peel it before freezing, then grate into hot water with a microplane or cheese grater) or as a concentrate. For a concentrate, search for recipes for homemade ginger ale or homemade ginger tea for one that sounds good to you. Follow the recipe, but don’t do the final step of adding additional water to dilute it. You can freeze the syrup in an ice cube tray and dilute it when needed. I also dried ginger tea bags on hand for emergencies.

Peppermint: Peppermint tea can also soothe nausea. Any tea aisle in a grocery store will yield many options for peppermint tea. Find one that sounds good to you, though be aware that some contain caffeine. Like ginger, fresh peppermint can be into tea. Just tear up a handful of fresh mint and steep it in two cups boiling water (adjust the amount of mint according to taste). Some people find peppermint candy to be helpful for nausea; others find it is too sweet or too strong to help. Since peppermint candies are everywhere, it’s an easy thing to try in a pinch.

Aromatherapy: In addition to making teas with or eating ginger or peppermint, smelling the essential oils can provide relief from nausea and vomiting.² Lemon oil might also be effective, according to one study.³ It’s important to use pure, high-quality oils (learn more about aromatherapy for migraine). If you don’t want to be seen sniffing a bottle at work or your son’s soccer games, you can put essential oils on a pendant and wear as a necklace.

Acupressure wristbands: Intended for motion sickness, you wear these fabric cuffs like bracelets. Each one has a button that you align with a certain pressure point, which is thought to relieve nausea. Whether or not you believe acupressure has scientific validity, it might be worth trying these wristbands. They cost about $10 (and are infinitely reusable), have no side effects, and can be used in conjunction with any other treatment. Brand names include Sea-Band and Psi Band.

Marijuana: Nausea relief is one of marijuana’s most highly touted medical uses.⁴ While it’s not for everyone, I’d be remiss in not mentioning it as a possibility for managing nausea. You can learn about medical marijuana and migraine in this Q&A article. Be aware that if relieving nausea is your goal, smoking or vaporizing is probably more effective than eating it. One patient interviewed for Mirgraine.com’s patient perspectives on marijuana said that marijuana treated their nausea more than their pain.