Outpatient treatment of migraine headache, can we use a dexamethasone containing regimen?

Abstract

• BACKGROUND: This research is aimed at determining the efficacy of intravenous dexamethasone and metoclopramide for treatment of acute migraine. Dexamethasone is a well-known drug for treatment of long lasting and recurrent migraine headaches. Metoclopramide is also used singularly or as an adjunct to treat the migraine attacks.
• METHODS: In a simple randomized study, patients with acute migraine were administered either intravenous dexamethasone and metoclopramide or intramuscular dihydroergotamine. Headache and concurrent symptoms were rated at baseline and 1, 2, 4 and 24 hours post-injection. .
• RESULTS: Analysis of headache severities indicated significant alleviation in both groups with time (p < 0.001). Side effects and concurrent symptoms did not show any significant difference between the two studied groups.
• CONCLUSIONS: In emergency department, intravenous dexamethasone and metoclopramide may be considered as an effective and available treatment with few side effects especially for patients with long-lasing and intractable migraine attacks; however, it must be used limitedly.
• KEYWORDS: Dexamethasone, metoclopramide, dihydroergotamine, migraine.