Migraine can cause extreme, pounding pain, typically on one side of the head, that can feel debilitating. Often, migraine pain is accompanied by nausea and vomiting.
It’s been shown that vomiting may, in some instances, alleviate or halt migraine pain. In fact, some people with migraine induce vomiting in order to make their head pain stop. Learn more about migraine and vomiting, and explore the reasons why vomiting can sometimes have this effect.
Self-induced vomiting is not advised for the treatment of migraine.
It’s not definitively known why vomiting stops migraine pain for some individuals. There are several possible explanations.
A 2013 study hypothesized several reasons why vomiting may halt migraine pain.
In an interview with Healthline, Rachel Colman, MD, headache specialist at the Hartford HealthCare Headache Center, further explained these hypotheses and more.
- End-of-a-migraine hypothesis. Some researchers believe that vomiting simply represents the final stage of a migraine attack’s progression.
- According to Colman, “[v]omiting for some marks the end of a migraine. For others, it is merely a feature that accompanies migraine. It’s not fully understood why a migraine may end with vomiting. During a migraine, the gut slows or even stops moving (gastroparesis). As the migraine ends, the gut begins to move again, and the vomiting is an accompanying feature of the migraine ending, as the GI tract starts to work again.”
- Reduced sensory input hypothesis. Vomiting may induce pain-relieving effects by eliminating sensory input to the gut.
- “Or, conversely, once the GI tract rids itself of the sensory stimuli, it aids in a feedback loop to stop the migraine,” Colman says.
- Complex interaction hypothesis. Migraine pain may stop as a result of interactions between the body’s various nervous systems.
- “Another theory,” Colman says, “is that a migraine [attack] is a complex interaction by the central nervous system, the enteric nervous system (in the gut), and the autonomic nervous system. Vomiting is seen to be the final process of these interactions, and vomiting hallmarks the shutting down of the migraine.”
- Vagus nerve hypothesis. One hypothesis involves the vagus nerve, a cranial nerve that’s stimulated by vomiting.
- “It’s well known that vagal stimulation can lead to breaking of migraine, as there are medications categorized as vagal nerve stimulators available that have [received FDA clearance] to treat a migraine attack,” Colman says.
- Neuropeptide hypothesis. Vomiting may elicit involuntary chemical effects that work to diminish migraine pain. One example is the release of the hormone arginine-vasopressin (AVP), also known as vasopressin.
- “Vomiting may also lead to more arginine-vasopressin (AVP) release,” Colman says. “AVP increases have been associated with relief of migraine.”
- Peripheral vasoconstriction hypothesis. Vomiting may also trigger involuntary vascular effects that diminish migraine pain.
- “Finally, vomiting can cause peripheral blood vessel vasoconstriction, which could, in turn, reduce blood flow to pain sensitized vessels, leading to a decrease in pain,” Colman states.
Experts are unsure what causes migraine attacks, but a variety of triggers are associated with the condition, including:
- bright lights
- loud noise
- the weather, including heat and changes in barometric pressure
- hormonal changes that occur during phases such as menstruation, pregnancy, or menopause
- low estrogen levels in people who are female
- intense exercise
- too much screen time
- medications, such as birth control pills
- certain foods, like chocolate, nuts, and aged cheeses (which all contain moderate or high amounts of the amino acid tyramine)
- gluten, for people with celiac disease
- too much caffeine
Nausea and vomiting are symptoms commonly associated with migraine. This may be because the gut and brain are connected and able to communicate with each other. An example of this connection is the butterflies you feel in your stomach when you’re nervous.
- The gut-brain axis. Communication between the gut and brain is bidirectional. The brain can send messages to the gut, and the gut can also send messages to the brain. This is known as the gut-brain axis. It connects the central nervous system to the enteric nervous system through the vagus nerve, which runs from the brain to the gut.
- Abdominal migraine. Abdominal migraine is a specific type of migraine that typically occurs in children. Nausea and vomiting are known symptoms of this condition. Abdominal migraine pain centers in the stomach rather than in the head. Children prone to abdominal migraine often have migraine attacks as adults.
- Cyclical vomiting syndrome. Cyclical vomiting syndrome is a variant of migraine most commonly seen in children. A severe episode of nausea and vomiting lasts for a few hours or a few days, and it’s followed by a symptom-free period. Episodes may occur with regularity and follow a pattern, or they may occur randomly.
In addition to nausea and vomiting, other migraine symptoms may include:
Treatments for nausea and vomiting associated with migraine include taking anti-nausea medication. Your doctor will most likely recommend that you take these in addition to pain-relieving medications.
Anti-nausea medications include:
- metoclopramide (Reglan)
- prochlorperazine (Procomp)
There are also home remedies and over-the-counter solutions that may help alleviate nausea during migraine. These include:
- taking motion sickness medication
- avoiding constrictive clothing around your abdomen
- using an ice pack or cold compress on the back of your neck or on the area where you feel head pain
- sucking on ice chips or drinking small sips of water to stay hydrated
- sucking on raw ginger or ginger candy, drinking ginger tea, or drinking ginger ale
- avoiding foods with strong tastes or smells
- avoiding contact with strong-smelling substances, such as dog or cat food, kitty litter, or cleaning products
- opening the window to let fresh air in, provided that the air outside does not have a smell you’re sensitive to, such as car exhaust
The best way to prevent migraine is to identify your migraine triggers and stay away from them as often as you can. Apps are available to help you track your symptoms.
You can also choose to take a prophylactic, or preventive, medication. Medications for migraine prevention come in many forms, such as pills, intravenous infusions, and eye drops. They include:
- calcitonin gene-related peptide (CGRP) receptor agonists, such as:
- anticonvulsant medications, such as:
- beta-blockers, such as:
- antidepressants, such as amitriptyline and venlafaxine (Effexor XR)
The Food and Drug Administration (FDA) has approved all CGRP receptor agonists and some medications from the other drug classes for the treatment of migraine.
The following medications from the list above are not FDA-approved to treat migraine: gabapentin, metoprolol, InnoPran XL, and antidepressants. They’re considered off-label treatments.
Off-label drug use
Off-label drug use means a drug that’s approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that has not yet been approved.
However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs but not how doctors use drugs to treat their patients. So your doctor can prescribe a drug however they think is best for your care.
Nausea and vomiting are common symptoms of migraine. Migraine attacks combined with these symptoms can feel debilitating, stopping you from enjoying and participating in life.
One interesting note is that vomiting does seem to alleviate or even stop migraine pain completely for some people. The reason for this is not completely understood, though several hypotheses hold promise.
If you have nausea and vomiting related to migraine, contact your doctor. They can help you find relief.
Editor’s note: This article was originally published on March 19, 2020. Healthline interviewed Rachel Colman, MD earlier that same year.