KETOROLAC VS CHLORPROMAZINE IN THE TREATMENT OF ACUTE MIGRAINE WITHOUT AURA - A PROSPECTIVE, RANDOMIZED, DOUBLE-BLIND TRIAL

Background: Many treatments for acute migraine exist. Chlorpromazine i s effective but has serious side effects. Ketorolac has only rare side effects. Objective: To compare intramuscular ketorolac tromethamine w ith intravenous chlorpromazine hydrochloride in treating acute migrain e. Methods: We performed a prospective, randomized, double-blind trial comparing the clinical effectiveness of 60 mg of intramuscular ketoro lac tromethamine with 25 mg of intravenous chlorpromazine hydrochlorid e in patients with acute migraine headache seen in the emergency depar tment. Pain intensity, quantitated using the Wong-Baker Faces Rating S cale, was measured every 30 a minutes for 2 hours in the emergency dep artment. Patients returned pain scores at 6, 12, 24, and 48 hours by m ail. Results: Fifteen patients were entered into each treatment arm. N o differences were seen between the mean pain scores or the mean chang e in pain scores. The ketorolac group mean (+/-SEM) pain score decreas ed from 4.07+/-0.18 to 0.73+/-0.3 in 2 hours. The chlorpromazine group pain score decreased from 4.47+/-0.17 to 0.87+/-0.4. Two of the 3 non responders responded to the alternate group's treatment. No side effec ts were seen. Conclusion: Using 60 mg of intramuscular ketorolac trome thamine is as effective as 25 mg of intravenous chlorpromazine hydroch loride in the treatment of acute migraine headache. Patients who do no t respond to one of these medications may respond to the other.