Prednisone for Migraine Headaches: An Emergency Department Randomized Double-Blind Placebo-Controlled Trial

Objective Migraine is a leading headache etiology that frequently presents to the emergency department (ED). In the present study, we aimed to determine the efficacy of dexketoprofen in aborting migraine headaches in the ED. Methods This prospective, randomized, double-blind study was conducted in an ED of a tertiary care hospital using allocation concealment. Patients were allocated into two arms to receive the study drug; 50 mg dexketoprofen in 50 ml saline and 50 ml saline as placebo. Change in pain intensity was measured by the visual analog scale at baseline, both at 30 and 45 minutes after the study medication was administered. Rescue medication requirement and pain relapse were also recorded by a telephone follow-up at 48 hours. Results A total of 224 patients (112 in each group) were included into the final analysis. Mean age of the study participants was 37 ± 11 (SD) and 25% ( n = 56) of them were male. The median pain improvement at 45 minutes for patients receiving dexketoprofen was 55 (IQR: 49 to 60) and 30 (IQR: 25 to 35) for those receiving placebo. The mean difference between the two groups at 45 minutes was 21.4 (95% CI: 14.4. to 28.5). Rescue drugs were needed in 22.3% of patients who received dexketoprofen compared to 55.4% in patients who received placebo (dif: 33.1%; 95% CI: 20% to 45%). There were no adverse events reported in either group during the study period. Conclusion Intravenous dexketoprofen is superior to placebo in relieving migraine headaches in the ED. It may be a suitable therapy with minimum side effects in patients presenting with a migraine headache to the ED.

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Randomized, double-blind, placebo-controlled trial of intravenous salbutamol and nebulized ipratropium bromide in early management of severe acute asthma in children presenting to an emergency department

Critical Care Medicine ◽

10.1097/00003246-200202000-00030 ◽

2002 ◽

Vol 30 (2) ◽

pp. 448-453 ◽

Cited By ~ 29

Author(s):

Gary J. Browne ◽

Lawrence Trieu ◽

Peter Van Asperen

Keyword(s):

Emergency Department ◽

Ipratropium Bromide ◽

Acute Asthma ◽

Controlled Trial ◽

Double Blind ◽

Early Management ◽

Double Blind Placebo ◽

Severe Acute Asthma ◽

Asthma In Children

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Faculty Opinions recommendation of Randomized double-blind placebo-controlled trial of two intravenous morphine dosages (0.10 mg/kg and 0.15 mg/kg) in emergency department patients with moderate to severe acute pain.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1071899.524833 ◽

2007 ◽

Author(s):

Patrick Ray

Keyword(s):

Emergency Department ◽

Acute Pain ◽

Controlled Trial ◽

Double Blind ◽

Double Blind Placebo ◽

Intravenous Morphine ◽

Emergency Department Patients

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360: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate 4% Liposomal Lidocaine Cream on Pain and Anxiety During Venipuncture in Pediatric Patients Who Present to the Emergency Department

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2009.06.392 ◽

2009 ◽

Vol 54 (3) ◽

pp. S113-S114

Author(s):

J. Boucher ◽

V. Rupp ◽

J. Bokovoy ◽

S. Hamilton ◽

K. Fredericks ◽

...

Keyword(s):

Emergency Department ◽

Pediatric Patients ◽

Controlled Trial ◽

Double Blind ◽

Double Blind Placebo

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A Prospective, Multicenter, Randomized, Double Blind, Placebo-Controlled Trial to Evaluate the Efficacy of Patent Foramen Ovale Closure with the STARFlex Septal Repair Implant to Prevent Refractory Migraine Headaches: the MIST Trial: S61.002

Neurology ◽

10.1212/01.wnl.0000234883.34790.8d ◽

2006 ◽

Vol 67 (1) ◽

pp. 185-185 ◽

Cited By ~ 16

Author(s):

A. J. Dowson ◽

P. Wilmshurst ◽

K. W. Muir ◽

M. Mullen ◽

S. Nightingale

Keyword(s):

Patent Foramen Ovale ◽

Controlled Trial ◽

Foramen Ovale ◽

Double Blind ◽

Double Blind Placebo ◽

Migraine Headaches ◽

Refractory Migraine

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Intravenous magnesium for acute benign headache in the emergency department: a randomized double-blind placebo-controlled trial

CJEM ◽

10.1017/s1481803500009593 ◽

2004 ◽

Vol 6 (05) ◽

pp. 327-332 ◽

Cited By ~ 10

Author(s):

Leonard R. Frank ◽

Carin M. Olson ◽

Klaus B. Shuler ◽

Salma F. Gharib

Keyword(s):

Emergency Department ◽

Group Treatment ◽

Magnesium Deficiency ◽

Controlled Trial ◽

Pain Scale ◽

Teaching Hospitals ◽

Double Blind ◽

Double Blind Placebo ◽

Significant Difference ◽

Headache Pain

ABSTRACT Background: Magnesium deficiency may play a role in the pathogenesis of migraines and other headaches. Studies in outpatient clinics have found that magnesium administered intravenously (IV) reduces headache pain. We investigated the effectiveness of IV magnesium in patients with acute benign headache who presented to the emergency department (ED). Methods: This randomized double-blind placebo-controlled trial compared 2 g of IV magnesium versus placebo for the treatment of patients with acute benign headache who presented to the EDs of two teaching hospitals. Pre- and post-treatment pain scores were measured on a 100-mm visual analog pain scale. Results: Forty-two patients were randomized, 21 in each treatment group. Treatment groups had similar baseline characteristics. After treatment, placebo recipients reported an 8-mm median improvement in pain, and magnesium recipients had a 3-mm improvement (p = 0.63). We found no statistically significant difference between groups for any secondary outcomes; however, the patients who received magnesium had significantly (p = 0.03) more side effects than did those in the placebo group. Conclusions: We found no benefit to using IV magnesium to treat patients with acute benign headache who present to the ED.

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