Abstract
OBJECTIVE: To establish whether there is any difference in the efficacy of a chlorpromazine regimen and a sumatriptan regimen for the management of the pain of acute severe migraine. SETTING: Two urban teaching hospital emergency departments. METHODS: Prospective, randomised, unblinded, crossover trial. All patients received intravenous metoclopramide 10 mg and 1000 ml of normal saline over 1 h; 20 were then randomised to receive intramuscular sumatriptan 6 mg and 23 to receive intravenous chlorpromazine, 12.5 mg increments to a maximum of 37.5 mg. Response to treatment was measured using visual analogue pain scales. RESULTS: No difference in efficacy between the sumatriptan regimen and the chlorpromazine regimen was found. Adverse effects were mild and equally distributed between the groups. CONCLUSIONS: The chlorpromazine and sumatriptan regimens studied are both very effective for the relief of the headache of severe migraine.
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- Akpunonu B. E., Mutgi A. B., Federman D. J., Volinsky F. G., Brickman K., Davis R. L., Gilbert C., Asgharnejad M. Subcutaneous sumatriptan for treatment of acute migraine in patients admitted to the emergency department: a multicenter study. Ann Emerg Med. 1995 Apr;25(4):464–469. doi: 10.1016/s0196-0644(95)70259-8. [DOI] [PubMed] [Google Scholar]
- Bell R., Montoya D., Shuaib A., Lee M. A. A comparative trial of three agents in the treatment of acute migraine headache. Ann Emerg Med. 1990 Oct;19(10):1079–1082. doi: 10.1016/s0196-0644(05)81507-0. [DOI] [PubMed] [Google Scholar]
- Cady R. K., Wendt J. K., Kirchner J. R., Sargent J. D., Rothrock J. F., Skaggs H., Jr Treatment of acute migraine with subcutaneous sumatriptan. JAMA. 1991 Jun 5;265(21):2831–2835. [PubMed] [Google Scholar]
- Cameron J. D., Lane P. L., Speechley M. Intravenous chlorpromazine vs intravenous metoclopramide in acute migraine headache. Acad Emerg Med. 1995 Jul;2(7):597–602. doi: 10.1111/j.1553-2712.1995.tb03596.x. [DOI] [PubMed] [Google Scholar]
- Goadsby P. J., Edvinsson L. The trigeminovascular system and migraine: studies characterizing cerebrovascular and neuropeptide changes seen in humans and cats. Ann Neurol. 1993 Jan;33(1):48–56. doi: 10.1002/ana.410330109. [DOI] [PubMed] [Google Scholar]
- Iserson K. V. Parenteral chlorpromazine treatment of migraine. Ann Emerg Med. 1983 Dec;12(12):756–758. doi: 10.1016/s0196-0644(83)80251-0. [DOI] [PubMed] [Google Scholar]
- Lane P. L., McLellan B. A., Baggoley C. J. Comparative efficacy of chlorpromazine and meperidine with dimenhydrinate in migraine headache. Ann Emerg Med. 1989 Apr;18(4):360–365. doi: 10.1016/s0196-0644(89)80570-0. [DOI] [PubMed] [Google Scholar]
- Lane P. L., Ross R. Intravenous chlorpromazine--preliminary results in acute migraine. Headache. 1985 Sep;25(6):302–304. doi: 10.1111/j.1526-4610.1985.hed2506302.x. [DOI] [PubMed] [Google Scholar]
- McEwen J. I., O'Connor H. M., Dinsdale H. B. Treatment of migraine with intramuscular chlorpromazine. Ann Emerg Med. 1987 Jul;16(7):758–763. doi: 10.1016/s0196-0644(87)80569-3. [DOI] [PubMed] [Google Scholar]
- Tek D. S., McClellan D. S., Olshaker J. S., Allen C. L., Arthur D. C. A prospective, double-blind study of metoclopramide hydrochloride for the control of migraine in the emergency department. Ann Emerg Med. 1990 Oct;19(10):1083–1087. doi: 10.1016/s0196-0644(05)81508-2. [DOI] [PubMed] [Google Scholar]
- Tfelt-Hansen P., Olesen J., Aebelholt-Krabbe A., Melgaard B., Veilis B. A double blind study of metoclopramide in the treatment of migraine attacks. J Neurol Neurosurg Psychiatry. 1980 Apr;43(4):369–371. doi: 10.1136/jnnp.43.4.369. [DOI] [PMC free article] [PubMed] [Google Scholar]