title: Comparison of therapeutic effects of magnesium sulfate vs. dexamethasone/metoclopramide on alleviating acute migraine headache.
abstract: BACKGROUND
  There is controversy about the efficacy of currently used treatment modalities to alleviate migraine headaches.
  
  
  OBJECTIVE
  We aimed to evaluate and compare the effects of magnesium sulfate and combined use of dexamethasone/metoclopramide on relieving acute migraine headache.
  
  
  METHODS
  We randomly divided 70 patients who had been referred to an emergency department, into two equal treatment groups with the two treatment plans, and analyzed pain severity at baseline using a numeric rating scale (NRS). We gave dexamethasone/metoclopramide to one group and magnesium sulfate to the other group, and evaluated pain severity at 20 min and at 1- and 2-h intervals after infusion. Finally, we used repeated-measure and two-way analysis of variance for intra- and inter-group evaluations of pain severity and complications, respectively.
  
  
  RESULTS
  We found no significant differences in demographic data and pain severity at baseline (8.2 vs. 8.0) between the two groups (p < 0.05). In the dexamethasone/metoclopramide group, pain severity (mean ± standard deviation) was 7.4 ± 1.4 (p = 0.36), 6.0 ± 2.4, and 2.5 ± 2.9 (p < 0.0001) at 20-min, 1-h, and 2-h intervals after treatment, respectively, with statistically significant differences between the baseline values and 1-h and 2-h interval values. Administration of magnesium sulfate was associated with decreased pain severity at the three intervals (5.2 ± 1.7, 2.3 ± 1.9, and 1.3 ± 0.66, respectively), exhibiting significant differences compared to baseline values and the corresponding time intervals in the dexamethasone/metoclopramide group (p < 0.0001).
  
  
  CONCLUSIONS
  According to the results, magnesium sulfate was a more effective and fast-acting medication compared to a combination of dexamethasone/metoclopramide for the treatment of acute migraine headaches.
authors.affiliation: Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Shahrami
authors.affiliation: Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Farhad
authors.initials: F
authors.lastname: Assarzadegan
authors.affiliation: Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Hatamabadi
authors.affiliation: Harvard University, School of Public Health, Boston, Massachusetts.
authors.forename: Morteza
authors.initials: M
authors.lastname: Asgarzadeh
authors.affiliation: Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Baharak
authors.initials: B
authors.lastname: Sarehbandi
authors.affiliation: Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Setareh
authors.initials: S
authors.lastname: Asgarzadeh
mesh_terms: D000208:Acute Disease; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003907:Dexamethasone / Q000627:therapeutic use*; D065127:Dopamine D2 Receptor Antagonists / Q000627:therapeutic use*; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use*; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000700:Analgesics; D000893:Anti-Inflammatory Agents; D065127:Dopamine D2 Receptor Antagonists; D004338:Drug Combinations; D008278:Magnesium Sulfate; D003907:Dexamethasone; D008787:Metoclopramide
keywords: dexamethasone; magnesium sulfate; metoclopramide; migraine; treatment