A new analysis of the National Headache Foundation's landmark American Migraine Prevalence and Prevention (AMPP) Study, the largest study of migraine and headache sufferers ever conducted, indicates that those with frequent migrainerelated nausea experienced more severe pain and worse outcomes than those with rare or no presence of nausea. Frequent nausea may also be a predictor of patients' satisfaction with their treatments and ability to perform everyday activities. These findings, which will be presented at the 53rd Annual Scientific Meeting of the American Headache Society (AHS), suggest that treating nausea may reduce the overall burden of migraine for certain EM (episodic migraine) patients, particularly for women, who experience migraine-related nausea more frequently than men (52.6 percent vs. 39.3 percent).

"These data suggest that there are millions of people who, because of migraine-related nausea as well as pain, are having a hard time finding relief from medication," said Dr. Richard B. Lipton, lead study investigator, professor/vice chair of The Saul R. Korey Department of Neurology at the Albert Einstein College of Medicine, and director of the Montefiore Headache Unit in New York. "Some patients with nausea delay or skip taking their oral treatment. Recognizing nausea may be a key to reducing the overall burden of migraine for certain episodic migraine sufferers."

Episodic migraine is one of the most common chronic pain conditions, affecting more than 29.5 million Americans, with women affected three times as frequently as men. Still, less than half of all people with migraine have consulted a healthcare professional for headache in the past year.

In this analysis of the AMPP Study, EM patients who frequently experienced nausea with migraine also had greater odds of experiencing other symptoms, including:

- One-sided pain
- Throbbing or pulsating pain
- Sensitivity to light, sound and/or smell
- Loss of appetite
- Neck pain
- Sinus pain

"These findings shine a light for the first time on just how serious an impact migraine-related nausea can have on people's lives," said Robert Dalton, executive director of the National Headache Foundation. "These data underscore that those who have frequent migraine-related nausea fare worse on several levels than those who don't. There is a clear need for more dialogue between healthcare providers and migraineurs to ensure patients receive relief from all the symptoms of migraine, including debilitating nausea."

Patients in the study who experienced frequent migraine-related nausea also reported less satisfaction with medications, including:

- Greater dissatisfaction with medication effectiveness
- More medication side effects
- More medication-related interference in several aspects of life, including their ability to work, perform household work, spend time with family, and pursue social and leisure activities

This analysis of the AMPP Study was conducted for the National Headache Foundation through funding from NuPathe Inc.

About Migraine

More than 29.5 million Americans suffer from migraine, with women being affected three times more often than men. Migraine is most commonly experienced between the ages of 15 and 55, and 70-80 percent of those affected have a family history of migraine. Less than half of all migraine sufferers have received a diagnosis of migraine from their healthcare provider. Migraine is often misdiagnosed as sinus headache or tension-type headache.

Migraine is characterized by throbbing pain, usually located on one side of the head, often accompanied by nausea and sensitivity to light and sound. The combination of disabling pain and associated symptoms often prevents people with migraine from performing daily activities. Symptoms, incidence and severity vary by individual. Attacks can last anywhere from four to 72 hours and the pre- and post-headache phases can last for hours to days, with symptoms such as muscle tenderness, fatigue and mood changes.

About the American Migraine Prevalence and Prevention (AMPP) Study

The AMPP Study is based on data compiled from 2004 through 2009 examining nearly 163,000 Americans ages 12 and older selected to be representative of the U.S. population. Based on a validated questionnaire, researchers reviewed headache symptoms and frequency, impairment, current or past use of migraine prevention medications (prescribed and/or over-the-counter) and use of medications prescribed for other indications, but known to prevent migraine headaches (coincident use).

National Headache Foundation