Intravenous metoclopramide in the treatment of acute migraines: A randomized, placebo‐controlled trial

• Published in: Acta neurologica Scandinavica Vol. 139; no. 4; pp. 334 - 339
• Main Authors: Doğan, Nurettin Özgür, Pekdemir, Murat, Yılmaz, Serkan, Yaka, Elif, Karadaş, Adnan, Durmuş, Uğur, Avcu, Nazire, Koçkan, Esra
• Format: Journal Article
• Language: English
• Published: Denmark Hindawi Limited 01-04-2019
• Subjects: Administration, Intravenous; Adult; Dopamine D2 Receptor Antagonists - administration & dosage; Double-Blind Method; emergency department (MeSH Database); Female; Headache; Humans; Intravenous administration; Male; Metoclopramide; Metoclopramide - administration & dosage; Migraine; Migraine Disorders - drug therapy; Patients; Treatment Outcome; emergency department (MeSH Database); migraine; headache; metoclopramide
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/ane.13063

Objectives
The present study aimed to evaluate the efficacy and safety of intravenous metoclopramide for acute migraine treatment.
Materials and methods
A double‐blind, randomized, parallel‐group, placebo‐controlled trial was carried out in an academic emergency department. After the patients were assessed for eligibility via the International Headache Society criteria for migraines, they were randomized into 10 mg intravenous metoclopramide and normal saline groups. The headache intensity was evaluated using an 11‐point numeric rating scale (NRS) score. The primary outcome measure was determined as the median between‐group change in the score at the 30th minute. The secondary outcome measures were rescue medication needs, adverse events, and emergency department (ED) revisits after discharge.
Results
A total of 148 patients were randomized into two equal groups with similar baseline characteristics, including the baseline NRS scores (8 points). The median reduction in the NRS scores at the 30th minute was 4 [interquartile range (IQR): 2‐6)] in the metoclopramide group and 3 (IQR: 1‐4) in the normal saline group [median difference: −1.0, 95% confidence interval (CI): −2.1 to 0.1]. No serious adverse events were observed, and the rescue medication needs were similar in both groups.
Conclusion
No difference was found between intravenous metoclopramide and placebo regarding efficacy and safety in patients with acute migraines.