Jd. Cameron et al., INTRAVENOUS CHLORPROMAZINE VS INTRAVENOUS METOCLOPRAMIDE IN ACUTE MIGRAINE HEADACHE, Academic emergency medicine, 2(7), 1995, pp. 597-602
Objective: To compare the efficacy of IV chlorpromazine with that of I
V metoclopramide in the treatment for acute migraine in the ED. Method
s: A prospective randomized double-blind trial was under taken at two
university-affiliated urban EDs with a combined annual census of more
than 85,000 patients. Included in the study were patients presenting t
o the ED with a diagnosis of migraine headache. The subjects were rand
omized to receive 0.1 mg/kg/dose IV of either chlorpromazine (CPZ) or
metoclopramide (MC), up to a total of three doses. Results: Ninety-one
patients completed the protocol; 44 received MC and 47 received CPZ.
The demographics of the two groups were similar. Both drugs provided,
for the majority of patients, adequate pain relief as measured on a vi
sual analog scale (VAS) completed every 15 minutes from T = 0 minutes
to T = 45 minutes. The average pain relief over 45 minutes (Delta VAS)
for CPZ was 4.87 cm, vs 4.34 cm for MC (p = 0.35). There also was no
statistically significant difference in blood pressure (BP) changes (D
elta BP < 2 mm Hg for both systolic and diastolic BPs, p = 0.47 and 0.
33) or numbers of patients reporting adverse effects (AEs) (CPZ: 16 of
35; MC: 13 of 29, p = 0.43). There was no severe AE with either study
drug. Conclusions: Metoclopramide and chlorpromazine administered IV
acute migraine headache. They are associated with similar minor side-e
ffect profiles.