title: Intramuscular prochlorperazine versus metoclopramide as single-agent therapy for the treatment of acute migraine headache.
abstract: To compare the efficacy of intramuscular prochlorperazine and metoclopramide in the short-term treatment of migraine headache in the emergency department 86 eligible adult patients with moderate to severe migraine headache were evaluated prospectively at a university-affiliated community hospital. After randomization, each subject received a 2-mL intramuscular injection of sterile saline, prochlorperazine (10 mg), or metoclopramide (10 mg). No other analgesics were administered during the 60-minute study period; patient assessment of relief was followed using visual analog scales. Reduction in median headache scores was significantly better among those treated with prochlorperazine (67%) compared to metoclopramide (34%) or placebo (16%). Similarly, symptoms of nausea and vomiting were significantly relieved in the prochlorperazine group (chi 2 = 17.1, P < .001). However, rescue analgesic therapy was necessary in the majority of patients treated with prochlorperazine (16/28) and metoclopramide (23/29) after the 60-minute study period. Although intramuscular prochlorperazine appears to provides more effective relief than metoclopramide, these results do not recommend either drug as single-agent therapy for acute migraine headache.
authors.affiliation: Department of Emergency Medicine, Butterworth Hospital, Michigan State University College of Human Medicine, Grand Rapids 49503, USA.
authors.forename: J
authors.initials: J
authors.lastname: Jones
authors.forename: S
authors.initials: S
authors.lastname: Pack
authors.forename: E
authors.initials: E
authors.lastname: Chun
mesh_terms: D000208:Acute Disease; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use*; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use*; D008881:Migraine Disorders / Q000188:drug therapy*; D010147:Pain Measurement; D011346:Prochlorperazine / Q000627:therapeutic use*; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D000932:Antiemetics; D008787:Metoclopramide; D011346:Prochlorperazine