Intravenous Ketorolac vs Intravenous Prochlorperazine for the Treatment of Migraine Headaches

Larkin, Gregory Luke

doi:10.1111/j.1553-2712.1999.tb00429.x

Cited by 21 publications

(7 citation statements)

References 11 publications

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“…It has also been found to work quickly, with limited side effects and limited addictive potential. [5][6][7][8][9] Its side effects include extrapyramidal effects, dysphoria, anxiety (akathisia) and sedation. Droperidol has also been used successfully for the treatment of migraine headaches.…”

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confidence: 99%

Droperidol vs. Prochlorperazine for Benign Headaches in the Emergency Department

Miner

Fish

Smith

et al. 2001

Academic Emergency Medicine

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Abstract. Objective: To compare the efficacy of droperidol with that of prochlorperazine for the treatment of benign headaches in emergency department (ED) patients. Methods: Prospective, randomized clinical trial in an urban ED. Patients were given either droperidol, 5 mg intramuscular (IM) or 2.5 mg intravenous (IV), or prochlorperazine, 10 mg IM or 10 mg IV. Measurements included side effects and the patient's pain perception as measured on a 100-mm visual analog scale (VAS) at baseline, 30, and 60 minutes after the medication was given. Data were analyzed using chi-square, two-tailed t-tests, and two-way analysis of variance (ANOVA) when appropriate. Results: During an eight-month period, 168 patients were enrolled. Eighty-two (48.8%) of the patients received droperidol; 86 (51.2%) received prochlorperazine. In the droperidol group, 49 (59.6%) received IM adminstration and 33 (40.4%) IV. In the prochlorperazine group, 57 (66.3%) received IM administration and 29 (33.7%) IV. Sixty minutes after the medication, the mean decrease in the VAS scores was 81.4% for droperidol and 66.9% for prochlorperazine (p = 0.001). At 30 minutes, 60.9% of the patients receiving droperidol and 44.2% of the patients receiving prochlorperazine had obtained at least a 50% reduction in their VAS scores (p = 0.09). At 60 minutes, 90.2% of the patients receiving droperidol and 68.6% of the patients receiving prochlorperazine had at least a 50% reduction in their VAS scores (p = 0.017). No difference between IM dosing and IV dosing was detected. Side effects, including dystonia, akathisia, and decreased level of consciousness, were seen in 15.2% of the patients receiving droperidol and 9.61% of the patients receiving prochlorperazine. No significant or persisting morbidity was detected. Conclusions: Droperidol was more effective than prochlorperazine in relieving pain associated with benign headaches.

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confidence: 99%

Droperidol vs. Prochlorperazine for Benign Headaches in the Emergency Department

Miner

Fish

Smith

et al. 2001

Academic Emergency Medicine

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“…Ketorolac is often used in the ED as monotherapy agent for a migraine attack or in combination with other drugs. In monotherapy, the response to ketorolac is 55.2% improvement . When patient receive a combination of prochlorperazine and ketorolac, the response goes up to 93% .…”

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confidence: 99%

“…In monotherapy, the response to ketorolac is 55.2% improvement. 18 When patient receive a combination of prochlorperazine and ketorolac, the response goes up to 93%. 19 The study also showed that the recurrence rate within 24 hours is higher with ketorolac alone at 30%.The dose used for ketorolac in the emergency room is 0.5 mg per kilogram intravenously with a maximum of 30 mg.…”

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confidence: 99%

Management of Pediatric Migraine Headache in the Emergency Room and Infusion Center

Kabbouche

2015

Headache

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Migraine is a common disorder that starts at an early age and takes a variable pattern from intermittent to chronic headache with several exacerbations throughout a lifetime. Children and adolescents are significantly affected. If an acute headache is not aborted by outpatient migraine therapy, it often causes severe disability, preventing the child from attending school and social events. Treating the acute severe headache aggressively helps prevent prolonged disability as well as possible chronification. Multiple medications are available, mostly for the outpatient management of an attack and include the use of over-the-counter anti-inflammatory medications as well as prescribed medications in the triptan group. These therapies do sometime fail and the exacerbation can last from days to weeks. If the headache lasts 72 hours or longer it will fall in the category of status migrainosus. Status migrainosus is described as a severe disabling headache lasting 72 hours or more by the ICHD3 criteria. Disability is a major issue in children and adolescents and aggressive acute measures are to be taken to control it as soon as possible. Early aggressive intravenous therapy can be very effective in breaking the attack and allowing the child to be quickly back to normal functioning. This article reviews what is available for the treatment of pediatric primary headaches in the emergency room.

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“…When administered as monotherapy, the response rate is about 53%, but the headache often recurs. When used in combination with prochlorperazine, the response rate is as high as 93% [2,10]. When taken early, NSAIDs are generally safe and effective in treating moderate to severe migraine.…”

Section: Pharmacologic Treatmentmentioning

confidence: 99%

Treatment of Acute Migraine in the Pediatric Population

O’Brien

Kabbouche

Hershey

2010

Curr Treat Options Neurol

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The recognition of the diagnosis of migraine in the pediatric population is increasing. Early and aggressive treatment of migraine in children and adolescents with the use of over-the-counter medications has proven effective. In addition, the off-label use of many migraine-specific medications is often accepted in the absence of sufficient evidence-based trials. Mild to severe cases of migraine should be treated with NSAIDs, with triptans used for moderate to severe headaches that are unresponsive to over-the-counter therapy. Rescue medication including dihydroergotamine (DHE) should be used for intractable migraines, preferably in the hospital setting. In patients with associated symptoms of nausea and vomiting, antiemetics with antidopaminergic properties can be helpful through their action on central migraine generation. Furthermore, patients and families should be educated about nonpharmacologic aspects of management such as preventing episodic migraine through lifestyle modification and avoidance of triggers.

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Intravenous Ketorolac vs Intravenous Prochlorperazine for the Treatment of Migraine Headaches

Cited by 21 publications

References 11 publications

Droperidol vs. Prochlorperazine for Benign Headaches in the Emergency Department

Droperidol vs. Prochlorperazine for Benign Headaches in the Emergency Department

Management of Pediatric Migraine Headache in the Emergency Room and Infusion Center

Treatment of Acute Migraine in the Pediatric Population

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