Migraines with severe vomiting

[ANNEBONNYBONES]

I suffer a lot of headaches and many 'potential' migraines that I knock on the head with painkillers / a triptan. I also get two or three full-blown attacks a year – which are absolutely horrendous.

The severe attacks start with the one-sided throbbing pain, followed a few hours later by the vomiting stage – which goes on for at least 8 hours. I throw up every 15 minutes, mainly bringing up bile, and get massively dehydrated. Once the vomiting subsides, the pounding headache goes on for another 8 hours or so before it eventually starts to subside.

My question is around the vomiting – I know there are medications to stop the sickness, does anyone find these successful? And although constantly being sick is really awful, I sometimes wonder if it's an important part of getting the migraine out of my system. If you stop the nausea, would the migraine take longer to go away or possibly come back? I've often noticed that if I successfully stop a migraine with a triptan, it just comes back the next day - and the day after that and so on, and I get caught in a real cycle of taking the drugs. It's as if my body needs to have a full-blown attack every now and then before I can feel well again – though, I'll do anything to stop a proper attack, as they really are unbearable!

You've just described mine! I've always had migraines but managed them with triptans, however I've had several over the past year with constant vomiting and horrendous pain. It's the worst misery! I saw the doctor and have a triptan to dissolve on my tongue and then put a buccastem (anti sickness) pill under my cheek and gum. I was also prescribed some anti sickness tablets that I take at the first signs of a migraine. Everything seems to be working and I've managed to stop a severe attack quite quickly recently. I hope you get somewhere

That's me. I have cyclizine for the sickness, topirimate at night and triptans for pain but I now just let them happen. I get them so often I have no choice. They are ruining my life

The worst misery for sure! Blooming awful.
Great to hear you’ve had some success… I haven’t seen a doc for such a long time about my migraines as the last time I tried, she literally said ‘come back when you’ve stopped taking so many painkillers’. I know I definitely get rebound headaches but it seems preferable to the alternative!!
I will look into the meds you mention.

You poor thing … that sounds so miserable. How many vomiting attacks do you get a month?
People with chronic migraines are apparently eligible to try out new preventative meds (injections etc) Have you looked into that at all?

I don't always get the vomiting. I get a 3 day migraine maybe twice a month where I end up in bed for 2 out of the 3 days. But I seem to have a manageable headache a few days through the week. Vomiting is probably every 2 months. I'm going to see GP tmrw so will mention it then as they're definitely getting more frequent and I'm wondering if it's age related. 51

Buccastem (you can buy over the counter) works to stop the worst of the vomiting for me and doesn't do that weird thing you describe where the migraine keeps trying to come back

Yup, same here. I’m 51 too, I’m wondering if HRT could help… or make them worse??!
I get ‘manageable’ headaches almost daily and know I’m stuck in a medication overuse situation but it’s so hard to break when you have to keep working and manage a family… and can’t afford to be in bed throwing up.
I recently read Managing Your Migraine by Dr Katy Munro and it’s a really useful overview of latest treatments and thinking. Recommend it.

I definitely think it's an age thing. I'm 51 and it's in the past year they have got worse in sickness terms and also length. I'm on HRT so I don't have the hormone drop inducing migraine but they now niggle away for 2-3 days before turning into one and then linger for a few days after. In all honesty I feel like I have a headache most days! I take regular pain relief for another condition but don't think that contributes to rebound ones, or does it? Don't put off seeing your doctor, they should listen and help. I write down notes to take in when I see a doctor to make sure I don't forget anything.

I use sickness patches because I can't keep meds down. I also have triptan nasal sprays.

If you're getting MOH, you absolutely need to cut down your meds. I did 2mths cold turkey about 20yrs ago and it was horrific, but absolutely needed.

You can't get on top of this until you've sorted that as you won't get any more help. I'm under neurology and they'll just refuse a referral if you're taking too much as its the first thing they require you to eliminate.

Frankly, I had fewer head head days without medication than I did with it after about 2wks.

I'm now on Aimovig injections and having ONE attack a month lasting about a day on average, down from my worst of 27 days per month.

Unfortunately regular painkillers, esp opiates like codeine, do cause rebound headaches. I’m allergic to aspirin and ibuprofen so it makes life difficult.
Yes, I will see doc again… hopefully a more sympathetic one! The last one made me feel like I was moaning about nothing… sadly even some docs don’t understand that migraine is definitely a lot more than just a headache!

Yes, I’m sure you’re right. Maybe I have to take 2 weeks’ holiday and spend it going cold turkey … such a miserable proposition but I’m so fed up of daily headaches.

I've had to have injections to stop vomiting as it had gone on for over 15 hours the game changer for me was the buccal tablets now as soon as I feel one coming on I put one under my gum and take the triptans.
If you get so many you should have a review, your preventative may need changing or there could be another medical reason if your pattern has changed.

I don’t vomit with my migraines because I’m an emetophobe. I take Domperidone with my Triptan as well as Buccastem.

I’m 52 and found my migraines were getting worse through lockdown, my GP refused to give me HRT so I contacted the National Migraine Centre. They did a treatment plan for me and sorted out my HRT. I,also, take Dolovent, it’s a supplement (I buy it from Amazon) on their recommendation which has helped a lot. I get Botox, on the NHS, too because of the amount I per month, however prior to lockdown I was having acupuncture which really helped but I let it lapse. I stared it up again last week and had one migraine on Friday, which went really swiftly and I didn’t feel sick at all.

I watched a tv prog, no idea what it was, and someone was like that for years and they found it was from her back being misaligned that she didn’t know about.

They fixed it and she got no more migraines.

I hope that helps someone as a visit to a physio could identify an issue that could be corrected? Yes it will cost like £50 or whatever but it could be worth considering.

I know someone is bound to be pissed off that I’m giving false hope or something but I’m only mentioning as if it were me I’d try any port in a storm as what you go through sounds horrific and it may be relevant to one of you. I hope you get it sorted.

Triptans work 9 times out of 10, but on those occasions where I start to vomit, it's game over. Only an anti sickness injection will help. It's always out of hours but I literally will vomit for days and the pain is indescribable.

That's why they put me on the buccal tablets I was going to hospital for injections. The tablets stay in place even if your sick and absorb directly into blood stream did they offer you them.