How to get rid of migraine without nausea

June 10, 2010 7:40 PM

TMI medical filter! I need help with migraine meds, nausea and constipation. Complicating factor: crappy insurance

I've got a great teaching job lined up for September, but the insurance won't kick in until October. Right now I'm on COBRA from my last job, and it's not great coverage.
So, I've found that generic Imitrex (100 mg) works pretty well for my migraines, but it really exacerbates my nausea (hot flashes, dizziness, upset stomach, very strong puke-y feeling, sometimes diarrhea, no actual vomiting, though) to a pretty much intolerable point. Pepto Bismol works really well for the nausea but it will bind me up very badly for days afterwards (to the point that laxatives don't do anything).
There is a generic Imitrex nose spray, but even with my insurance it's way too expensive for me (close to $100 for 6 5mg sprays). I feel pretty stuck with the pill form of Imitrex until October, when I'll be a state employee again - yay!. So, here are my questions:

Does anyone have any suggestions for something that will relieve my nausea symptoms without binding me up (without an anti-diarrhea ingredient, I suppose)?
Has anyone else had similar problems with migraine (medicine)-associated nausea? What helped you?

(I can use Excedrin migraine on occasion, but my stomach is pretty sensitive to caffeine, so there are times when it's just not an option.)
I think that I'm looking for more immediate solutions than, say trying Topamax or another preventative medication; I don't really want to wait a month before it kicks in, and given what I've read about Topamax's side effects, I'd rather exhaust other avenues before trying it. I was just diagnosed with migraines a little over a year ago (I thought they were sinus headaches), so I still don't have a really good sense of my triggers; I plan on getting into a headache clinic as soon as I can after October.

posted by queseyo to health & fitness (19 answers total)

Simple: Candied ginger, ginger Altoids -- these are for before its a full migraine nausea; white bread or saltines carried at all times
More serious: bonine (this is a motion sickness drug that's over the counter. love it)
Go-to-bed-disaster (prescription only): compazine (this was my keep me from going to the hospital option after the 4th time I ER'ed from migraine nausea thanks to dehydration). I have the kind that's suppository so I can just stop throwing up.

I also take 50mg of Imitrex twice, a few hours apart so see if I can hold off on taking the full 100 (it's a lifesaver, but it gives me HORRIBLE tightness in my neck and jaw).

No one I know loves Topamax btw. (As a writer, the side effect "loss for words" had me write it off immediately.)
posted by Gucky at 7:55 PM on June 10, 2010

Seconding compazine (prochlorperazine) for nausea. It's work on my migraine-related nausea. However, it makes me sleepy.
posted by cabingirl at 8:06 PM on June 10, 2010

I told my migraine guy "hell no" to Topamax and got Namenda instead. So far so good; keep it in mind when you go to the clinic.

Sniffing an alcohol wipe helps avert nausea.
posted by fairytale of los angeles at 8:21 PM on June 10, 2010

I've got promethazine for my nausea. When I get the migraines with nausea, I take it (and struggle for a few minutes not to throw up, as I can't keep anything but water down) and within half an hour it kicks in so I can eat. It then knocks me out for about four hours.

It also tends to dehydrate me, so fair warning - if you get it, make sure to drink as much water as you can. I do notice that WIkipedia lists constipation as a possible side effect. I don't get that (but it may be related to dehydration?).
posted by telophase at 8:49 PM on June 10, 2010

what about phenigren?
posted by TheBones at 8:59 PM on June 10, 2010

2nding the Bonine. Effective, cheap, easily gotten over the counter (in the U.S., at least) and I find that it doesn't make me drowsy. If you're okay with being drowsy, Dramamine is also a good option.
posted by corey flood at 9:08 PM on June 10, 2010

Another vote for Phenergan, it does a great job of stopping the nausea. Another suggestion is to try Tordal, which is an anti-inflammatory and doesn't cause any side effects. I have a prescription from my doctor for pills and when it's really bad I get a nurse's visit for an injection. If you can handle getting the shot in the hip, it stops the pain in about 20 minutes without any side effects.

Oh and when you get insurance, ask your doctor about Maxalt. The copay is a little more pricy but that stuff is the best. Stops the headache, blocks any stomach issues, and no hangover like you get with Imitrix.
posted by gov_moonbeam at 9:15 PM on June 10, 2010

What Gucky said. But regular old pot smoke (and only smoke) worked best for an ex GF with classic migraines like the ones you described. Fewer and less severe side effects than even the best short term emergency meds, cheaper than many alternatives if you have crappy insurance and it won't make you anywhere NEAR as stupid as Topomax.
posted by willie11 at 10:59 PM on June 10, 2010

Not sure if this med has already been mentioned (many names for the same med these days) but Zomig works great for getting rid of my migraines.

Only side effect I have is a very mild "funny" feeling in my nose. Not runny feeling or anything like that. Just some odd sensation that I notice every time I take it.

Just don't drink alcohol while taking Zomig! My BP skyrocketed when I did.

Best of luck to you!
posted by InsertNiftyNameHere at 12:02 AM on June 11, 2010

Are you sure you need meds?

For these symptoms good quality green tea seems ideal.
posted by knz at 12:14 AM on June 11, 2010

Green tea, ginger. These things work for some patients, but if you're experiencing the full onslaught of pain characteristic of the true migraineur, you need heavier artillery. I'm not a doctor or pharmacist, but I've heard that cannabis can work wonders for migraine nausea. If you can purchase it legally, it's recommended. You might also look into stronger meds such as Fioricet or Tylenol with codeine. Taking these is dangerous, due to addictive properties and rebound headaches, but I've found that they control both the pain and nausea. Fioricet is cheap and widely available online; it will run you a dollar or two a pill in most cases. Good luck.
posted by Gordion Knott at 2:41 AM on June 11, 2010

Here in California, medical marijuana is prescribed for both migraines and nausea. I don't know whether your job or your location might make marijuana an impossibility, however.
posted by zippy at 2:45 AM on June 11, 2010

I love Topamax. It changed my life. I know it's the case for many that the side effects are worse than the disease, but mine are minimal. I started with a tiny dose, graduated slowly, slept a lot initially, and now I have the life of a normal person. My vocabulary is more or less intact. It's definitely better than it was during the onset of a migraine or during a migraine hangover. I once thought carefully and at length before triumphantly producing the word "driveway."

I used to go through a box of six Imitrex nasal inhalers and several tablets every month. When I refilled my inhalers this month, I realized that my last refill was last October. It brought me to tears.

I've also lost about 25 pounds since November. Bonus!
posted by houseofdanie at 2:51 AM on June 11, 2010

I used to take Reglan for migraine nausea (years ago, but I don't recall any significant side effects).

I didn't have loss of words with Topomax, but it did exacerbate my anxiety to the point where I had to stop taking it. I've been on a beta blocker preventative for about 3 weeks, and it seems to have started working. There are plenty of generic brands, so it's another Topomax-alternative to consider.
posted by casualinference at 5:29 AM on June 11, 2010

If you can get over the atrocious name, many of my pregnant friends with rather significant morning sickness swear by Preggie Pop Drops for nausea.

I'm ordering some for myself for migraine nausea, but I can't personally vouch for its effectiveness quite yet.

BTW, I took Topamax for 2+ years, and most of the side effects subsided over time. Mine included decreased appetite, loss of words/fuzzy brain, and paresthesia. The one that didn't really diminish over time was decreased ability to sweat, meaning I could become dangerously overheated during exercise if I wasn't very careful. YMMV.
posted by somanyamys at 5:37 AM on June 11, 2010

When I was in chemotherapy I found that orange slush drinks and orange or other citrus flavours ice pops were very soothing for the nausea. It was the combination of citrus, sweet, and cold that worked for me and has become my sovereign remedy for nausea from all causes.
posted by angiep at 6:41 AM on June 11, 2010

I'm on Topomax and side effects haven't been a problem at all.

The first week or two I felt sort of off, and maybe a little dizzy at times, but since then, I've been fine - it doesn't seem to slow down my cognition and I don't have trouble recalling words at all. I know it has that effect for some people, but not for everyone - I'm a law student, I need my brain, I would have been off of it in a heartbeat if I felt like it was slowing me down. I don't have any parestheia, I might have a slightly decreased appetite. So, if it comes down to it, I wouldn't let the horror stories keep you from trying it out. It's relatively short acting, so if you don't like it, it'll be out of your system in a couple days once you stop taking it.
posted by insectosaurus at 8:14 AM on June 11, 2010

I'm on Doxepin to prevent migraines. I was shocked that it actually worked. I just assumed it wouldn't work and was surprised when it did. It makes me a little drowsy, so I take it at night. It's also very inexpensive.
posted by parakeetdog at 9:51 AM on June 11, 2010

I also have Reglan, which is an anti-nausea medication that sometimes will get rid of migraines by itself, as a weird side effect. There's a generic, so it was super cheap (like $2.50 for me, I think).

I have prescriptions for both Maxalt and Imitrex, and Maxalt actually upsets my stomach more (like 100% more), unlike gov_moonbeam, so YMMV.

Have you tried just taking 50mg first, before taking the full 100? With migraine meds, it's usually best to take as little as possible that will actually fully stop the migraine.

I'm sure the headache clinic will mention this when you go, but largish doses of Coenzyme Q-10, Magnesium, and B2 are all vitamins that have been shown to have a positive effect on the reoccurrence of migraines, though no one seems to know why. (Positive in that the migraines didn't occur as often, not positive as in raised the number of them.) IANAD, so be careful about other interactions and health problems, but I have personally really liked the Co-Q10.
posted by wending my way at 4:17 PM on June 11, 2010