Influential American medical organizations and publications have published guidelines for the treatment of acute migraine headaches that omit antiemetics, usually suggesting triptans as the first line of treatment. A review of the few comparative studies directly contrasting clinical outcomes of triptans and antiemetics in the treatment of acute migraines suggest that both treatment options are relatively equal in efficaciousness. The added burden of triptan usage, including an added risk of adverse effects and a high cost per dose, would seem to warrant an antiemetic-first approach to migraine treatment, as recommended by several international health communities. Possible reasons for the prominent omission of antiemetics from leading publications may include medical parochialism and pharmaceutical funding of medical research.
Reisman, S. (2015). Treating Acute Migraines: Triptans vs. Antiemetics. The Science Journal of the Lander College of Arts and Sciences, 8 (2). Retrieved from http://touroscholar.touro.edu/cgi/viewcontent.cgi?article=1058&context=sjlcas