NDLI: A Randomized Controlled Trial of Intravenous Haloperidol vs. Intravenous Metoclopramide for Acute Migraine Therapy in the Emergency Department.

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A Randomized Controlled Trial of Intravenous Haloperidol vs. Intravenous Metoclopramide for Acute Migraine Therapy in the Emergency Department.

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A Randomized Controlled Trial of Intravenous Haloperidol vs. Intravenous Metoclopramide for Acute Migraine Therapy in the Emergency Department.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Gaffigan, Matthew E. Bruner, David I. Wason, Courtney Pritchard, Amy Frumkin, Kenneth
Description	Author Affiliation: Gaffigan ME ( Naval Medical Center Portsmouth, Portsmouth, Virginia.); Bruner DI ( Naval Medical Center San Diego, San Diego, California.); Wason C ( Naval Medical Center Portsmouth, Portsmouth, Virginia.); Pritchard A ( Naval Hospital Camp Pendleton, Camp Pendleton, California.); Frumkin K ( Naval Medical Center Portsmouth, Portsmouth, Virginia.)
Abstract	BACKGROUND: Emergency Department (ED) headache patients are commonly treated with neuroleptic antiemetics like metoclopramide. Haloperidol has been shown to be effective for migraine treatment. STUDY OBJECTIVE: Our study compared the use of metoclopramide vs. haloperidol to treat ED migraine patients. METHODS: A prospective, double-blinded, randomized control trial of 64 adults aged 18-50 years with migraine headache and no recognized risks for QT-prolongation. Haloperidol 5 mg or metoclopramide 10 mg was given intravenously after 25 mg diphenhydramine. Pain, nausea, restlessness (akathisia), and sedation were assessed with 100-mm visual analog scales (VAS) at baseline and every 20 min, to a maximum of 80 min. The need for rescue medications, side effects, and subject satisfaction were recorded. QTc intervals were measured prior to and after treatment. Follow-up calls after 48 h assessed satisfaction and recurrent or persistent symptoms. RESULTS: Thirty-one subjects received haloperidol, 33 metoclopramide. The groups were similar on all VAS measurements, side effects, and in their satisfaction with therapy. Pain relief averaged 53 mm VAS over both groups, with equal times to maximum improvement. Subjects receiving haloperidol required rescue medication significantly less often (3% vs. 24%, p < 0.02). Mean QTcs were equal and normal in the two groups and did not change after treatment. In telephone follow-up, 90% of subjects contacted were 'happy with the medication' they had received, with haloperidol-treated subjects experiencing more restlessness (43% vs. 10%). CONCLUSIONS: Intravenous haloperidol is as safe and effective as metoclopramide for the ED treatment of migraine headaches, with less frequent need for rescue medications.
File Format	HTM / HTML
ISSN	07364679
Issue Number	3
Volume Number	49
Journal	The Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2015-09-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency medicine Dopamine Antagonists Therapeutic Use Dopamine D2 Receptor Antagonists Haloperidol Metoclopramide Migraine Disorders Drug Therapy Acute Disease Adolescent Adult Administration & Dosage Double-blind Method Emergency Service, Hospital Female Humans Injections, Intravenous Male Middle Aged Pain Measurement Prospective Studies Severity Of Illness Index Treatment Outcome Journal Article Randomized Controlled Trial
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine

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