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J Emerg Med. 2015 Jan;48(1):69-76. doi: 10.1016/j.jemermed.2014.06.055. Epub 2014 Sep 30.

Comparison of therapeutic effects of magnesium sulfate vs. dexamethasone/metoclopramide on alleviating acute migraine headache.

Author information

1
Shahid Beheshti University of Medical Science, Tehran, Iran.
2
Harvard University, School of Public Health, Boston, Massachusetts.

Abstract

BACKGROUND:

There is controversy about the efficacy of currently used treatment modalities to alleviate migraine headaches.

OBJECTIVE:

We aimed to evaluate and compare the effects of magnesium sulfate and combined use of dexamethasone/metoclopramide on relieving acute migraine headache.

METHODS:

We randomly divided 70 patients who had been referred to an emergency department, into two equal treatment groups with the two treatment plans, and analyzed pain severity at baseline using a numeric rating scale (NRS). We gave dexamethasone/metoclopramide to one group and magnesium sulfate to the other group, and evaluated pain severity at 20 min and at 1- and 2-h intervals after infusion. Finally, we used repeated-measure and two-way analysis of variance for intra- and inter-group evaluations of pain severity and complications, respectively.

RESULTS:

We found no significant differences in demographic data and pain severity at baseline (8.2 vs. 8.0) between the two groups (p < 0.05). In the dexamethasone/metoclopramide group, pain severity (mean ± standard deviation) was 7.4 ± 1.4 (p = 0.36), 6.0 ± 2.4, and 2.5 ± 2.9 (p < 0.0001) at 20-min, 1-h, and 2-h intervals after treatment, respectively, with statistically significant differences between the baseline values and 1-h and 2-h interval values. Administration of magnesium sulfate was associated with decreased pain severity at the three intervals (5.2 ± 1.7, 2.3 ± 1.9, and 1.3 ± 0.66, respectively), exhibiting significant differences compared to baseline values and the corresponding time intervals in the dexamethasone/metoclopramide group (p < 0.0001).

CONCLUSIONS:

According to the results, magnesium sulfate was a more effective and fast-acting medication compared to a combination of dexamethasone/metoclopramide for the treatment of acute migraine headaches.

KEYWORDS:

dexamethasone; magnesium sulfate; metoclopramide; migraine; treatment

PMID:
25278139
DOI:
10.1016/j.jemermed.2014.06.055
[Indexed for MEDLINE]

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