The efficacy of metoclopramide in the treatment of migraine headache.
OBJECTIVE
By evaluating the efficacy of metoclopramide alone and in combination with ibuprofen versus placebos, this study was designed to both evaluate the efficacy of metoclopramide and elucidate its mechanism of action in the treatment of migraine headache.


METHODS
The study was conducted over a two-year period and was a randomized, double-blind, placebo-controlled study.


METHODS
An urban teaching hospital.


METHODS
Patients enrolled were at least 18 years old and had recurring headaches with one or more of the following characteristics: unilateral, preceded by neurologic symptoms, significant nausea and vomiting, or mood changes and photophobia.


METHODS
Ten milligrams of metoclopramide or an equal volume of IV normal saline was given and 600 mg of ibuprofen or identical-appearing placebo was given orally at time 0. Patients rated their pain and nausea at time 0, 30 minutes, and 60 minutes using visual-analog scales.


RESULTS
The differences in pain and nausea scores for the metoclopramide + placebos group versus the other three groups were tested using exact nonparametric (Mann-Whitney) statistical procedures. The metoclopramide + placebos group had significantly better relief of pain compared with the placebos + ibuprofen and placebos + placebos groups. The metoclopramide + placebos group had significantly better relief of nausea than the ibuprofen + placebos group; nausea scores for the placebos + placebos group could not be analyzed due to excessive variance from the other groups at baseline. The differences between the metoclopramide + placebos group and the metoclopramide + ibuprofen group were not statistically significant with regard to either pain or nausea.


CONCLUSIONS
Metoclopramide is efficacious in the treatment of both the pain and nausea of migraine headache. This is a direct action that is not dependent on the concomitant administration of another agent.
Ellis
G L
GL
Department of Emergency Medicine, Western Pennsylvania Hospital, Pittsburgh.
Delaney
J
J
DeHart
D A
DA
Owens
A
A
D000293:Adolescent; D000328:Adult; D004311:Double-Blind Method; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D008787:Metoclopramide / Q000627:therapeutic use*; D008881:Migraine Disorders / Q000188:drug therapy*; D016896:Treatment Outcome
D008787:Metoclopramide; D007052:Ibuprofen