Buccally absorbed vs intravenous prochlorperazine for treatment of migraines headaches.

Authors:
Mai Shimada
Mai Shimada
Maimonides Medical Center
United States
Kabir Yadav
Kabir Yadav
Harbor-UCLA Medical Center
Torrance | United States
Timothy Horeczko
Timothy Horeczko
UC Davis School of Medicine
United States
David A Tanen
David A Tanen
Palmetto Richland Memorial Hospital
United States

Acta Neurol Scand 2019 Apr 16. Epub 2019 Apr 16.

Department of Emergency Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, California.

Objective: To compare the efficacy of buccally absorbed prochlorperazine (BAP) to intravenous prochlorperazine (IVP) for the abortive treatment of migraine headaches.

Methods: Randomized double-blind trial. Eighty subjects aged 18-65 presenting with migraines to the ED of a safety-net, urban hospital. Subjects were randomized to receive either 6 mg BAP plus 2.25 mL saline IV placebo or 10 mg IVP and buccally absorbed saccharine pill placebo. A 100 mm visual analog scale (VAS) was used to assess pain, nausea, and sedation. Comparisons between groups were analyzed by the Mann-Whitney U test or Fisher's exact test.

Results: Eighty subjects were recruited from November 2016 to December 2017; 79 completed the study. Demographics: 60 women and 19 men with a mean age of 38 ± 12.2 years. Initial mean VAS pain scores were similar between groups (BAP: 78.5 ± 19.9 mm vs IVP: 76.9 ± 19.5 mm). The improvement in mean VAS pain scores over 60 minutes for the BAP group was not significantly different from the IVP group (-54.9 ± 29.7 mm vs -66.7 ± 23.2 mm, respectively; P = 0.08). No significant differences were found in rates of nausea or sedation. Nine subjects in the BAP group required rescue treatment compared to 1 in the IVP group. Five subjects reported symptoms consistent with akathisia in the IVP group while no adverse effects were reported in the BAP group.

Conclusion: Buccally absorbed prochlorperazine (BAP) is an effective, non-invasive treatment for migraine headaches when compared to intravenous prochlorperazine (IVP).

Download full-text PDF

Source
https://onlinelibrary.wiley.com/doi/abs/10.1111/ane.13104
Publisher Site
http://dx.doi.org/10.1111/ane.13104DOI Listing
April 2019
4 Reads

Publication Analysis

Top Keywords

buccally absorbed
16
ivp group
12
intravenous prochlorperazine
12
bap group
8
nausea sedation
8
prochlorperazine bap
8
vas pain
8
pain scores
8
absorbed prochlorperazine
8
treatment migraine
8
prochlorperazine ivp
8
ivp
7
bap
7
prochlorperazine
5
subjects
5
group
5
analyzed mann-whitney
4
buccally
4
exact testresults
4
compared ivp
4

References

(Supplied by CrossRef)
The international classification of headache disorders, 3rd edition (beta version)
Headache Classification Committee of the International Headache Society (HIS) et al.
Cephalalgia 2013

Similar Publications