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Treating Migraine : Prescription Adjunctive Therapy

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Q: What is an adjunctive medication?
A: When a medication is used to treat a symptom of the condition, but not for treatment of the condition itself, it is called an adjunctive medication. In the treatment of migraine attacks, adjunctive medications can be used to treat nausea and vomiting or to cause sedation.
Q: Can adjunctive medications help with a migraine attack?
A: Yes. Some adjunctive medications can help abort a migraine attack because they act as sedatives (make you sleepy). Sleep can abort a migraine attack. Many anti-nausea medications cause sedation in addition to stopping nausea and vomiting and so can also help with the attack.
Q: How do antiemetics help during migraine attacks?
A: During an attack, nausea and vomiting can prevent you from eating or cause dehydration, which may make the attack last longer. Antiemetics (antinausea medications) will help you keep down food and liquids and can relieve the discomfort of nausea.
Q: How are sedatives used to treat migraine?
A: Sedatives are frequently prescribed for migraine attacks. However, they should be avoided because they can cause medication overuse headache. In some cases, sedation can be crucial. If a severe attack is not aborted within 2 hours with your usual medication, you need to repeat your initial medication and add something to make you sleepy. In this case, taking an antinausea medication that causes sedation will help you sleep and is better than taking a sedative.
Q: Is there a medication I can use for nausea that does not cause sedation?
A: Yes, you can use metoclopramide. This prescription medication does not cause sedation and can help with the absorption of your abortive migraine medications. You can take it with your abortive medications.

Drugs to treat nausea and vomiting

The most effective medication for the nausea and vomiting of a migraine attack is one that can alleviate the symptoms as quickly as possible. It is very important that these symptoms are controlled as soon as possible so you can drink water and eat. If you are unable to avoid hypoglycemia and dehydration, the migraine attack will worsen. Effective medication for nausea and vomiting must be available at all times. You will need to discuss the use of these medications with your doctor.

Table
AntiemeticDosageForm
Metoclopramide10mgpill
 5–10mginjection
Chlorpromazine10mgpill
 50mgsuppository
 25mginjection
Prochlorperazine10mgpill
 25mgsuppository
 10mginjection
Promethazine25–50mgpill
 25–50mgsuppository
 50–75mginjection
Hydroxyzine25–50mgcapsules
 75mginjection

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