CHAPTER 52 METOCLOPRAMIDE IN MIGRAINE

Metoclopramide vs. Hydromorphone for the Emergency Department Treatment of Migraine Headache

Griffith J, Mycyk MB, Kyriacou DN. J Pain. 2008;9(1):88–94

BACKGROUND

Twenty-eight million Americans suffer from headaches, and of these 15% seek ED evaluation at some point. Migraine headaches account for more than $17 billion in health care costs in the United States annually. At the time of this study, previously used treatments such as prochlorperazine and droperidol were not readily available secondary to shortages and black box warnings. Hydromorphone was often used, however, it was acknowledged that nonopiate options were preferable given the risk of addiction and adverse effects. Metoclopramide was identified as a useful abortive treatment but had not been studied in the ED setting.

OBJECTIVES

To compare the effectiveness of metoclopramide vs. hydromorphone for the initial treatment of migraine in ED patients.

METHODS

Retrospective cohort study at a single academic medical center in the United States.

Participants

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