Migraine-associated symptoms: clinical significance and management

Nausea is common in patients with migraine. A number of antiemetic drugs can be useful in migraine treatment, and those with a prokinetic action (metoclopramide and domperidone) may also improve gastrointestinal absorption of analgesics and triptans during a migraine attack. In addition to providing headache relief, the triptans are very effective in relieving migraine-associated nausea. For migraine patients with nausea and/or vomiting severe enough to interfere with the use of oral medications, alternative drug delivery methods can be used. These include the injectable, intranasal and rectal suppository routes, and specialized oral medications such as sublingual tablets and oral wafers that dissolve in the mouth. Fortunately, effective medications that use some of these alternative delivery routes have become more available over the past several years.