CHAPTER 51 PROCHLORPERAZINE IN MIGRAINE

Randomized, Placebo-Controlled Evaluation of Prochlorperazine vs. Metoclopramide for Emergency Department Treatment of Migraine Headache

Coppola M, Yealy DM, Leibold RA. Ann Emerg Med. 1995;26(5):541–546

BACKGROUND

Migraine is a common disease, affecting 29.5 million American adults, and resulting in over $700 million from migraine-related ED visits. Prochlorperazine, an antipsychotic of the phenothiazine class, and metoclopramide, a dopamine antagonist, are both used in the ED treatment of migraine; however, prior to this study it was not known which agent was superior in the treatment of migraine.

OBJECTIVES

To compare prochlorperazine and metoclopramide in the ED treatment of migraine.

METHODS

Prospective randomized double-blind placebo-controlled trial at a single US academic ED.

Patients

Seventy patients, between 18 and 65 years old, presenting with migraine headache similar to prior episodes with or without nausea, vomiting, photophobia, or phonophobia. Select exclusion criteria: Pregnancy, fever, meningismus, altered mental status, use of analgesics, drugs, or alcohol within 24 hours, oxygen saturation <90%, trauma or seizure within 24 hours, and hypertension.

Intervention Evaluated

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