What treatment options for acute migraine?

Updated: Oct 21, 2019
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Intravenous metoclopramide is recognized as an effective therapy for acute migraine, but the optimal dosing has not been established. A study by Friedman et al determined that 20 or 40 mg of metoclopramide is no better in the treatment of acute migraine than 10 mg of the drug. [93]

A systematic review by Taggart et al found that ketorolac is an effective alternative agent for the relief of acute migraine headache in the ED. Ketorolac provides pain relief similar to that with meperidine (with less potential for addiction) and is more effective than sumatriptan; however, it may not be as effective as metoclopramide/phenothiazine agents. Side-effect profiles were similar with ketorolac and these other agents. [94]


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