Large Study: Frequent Nausea Worsens Migraine Severity

by Rosemary Frei

Nausea does indeed make life more difficult for patients suffering from episodic migraine headaches and also complicates their treatment, results from the American Migraine Prevalence and Prevention (AMPP) study have confirmed.

An analysis presented by Richard Lipton, MD, at the American Headache Society’s annual meeting in Washington, D.C., indicated that nausea could severely impair patients with episodic migraine, particularly those with frequent nausea.

“These data validate what our patients tell us,” commented Lawrence C. Newman, MD, director, The Headache Institute, Roosevelt Hospital Center, New York City, who was not involved in the AMPP study. “Migraine is very commonly associated with nausea and the presence of nausea is disabling in its own right; plus the association of nausea often prevents or delays patients from treating their pain.”

Overall, women suffering from episodic migraine headaches were much more likely than men to have high-frequency nausea, with an odds ratio (OR) of 1.71 (95% confidence interval [CI], 1.52-1.93). Neither age nor income appears to be linked to nausea frequency; race, however, does. Blacks and Asians have significantly lower odds than whites of having high-frequency nausea, with ORs of about 0.6, whereas Native Americans have an OR of 1.85.

As Dr. Lipton and his colleagues reported in an oral presentation and an accompanying poster, patients who experience nausea at least half the time have significantly higher Migraine Disability Assessment (MIDAS) scores than those with nausea either never/rarely or less than half the time. Similarly, those with the most frequent nausea have significantly higher scores on the Headache Impact Test (HIT-6) and overall significantly higher headache impact, as measured by the HIT-6.

The investigators noted that having higher nausea frequency significantly worsens all of the items examined by HIT-6. This includes having more severe pain and more limited activities, the need to lie down often, being too tired for daily activities, feeling “fed up” or irritated and having a limited ability to concentrate.

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