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Review: intravenous metoclopramide is better than placebo for reducing pain in acute migraine in the emergency department

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 Q In patients with acute migraine, is metoclopramide more effective than a control intervention for reducing symptoms?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Neurology ★★★★★★☆ Emergency medicine ★★★★☆☆☆


Embedded ImageData sources:

Medline; EMBASE/Excerpta Medica; LILACS; CINAHL; Cochrane Central Register of Controlled Trials; neurology, headache, and emergency medicine conference proceedings (1998–2004); clinical practice guidelines; websites; theses or dissertations; reference lists; and experts in the field.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) that compared parenteral metoclopramide with placebo, other antiemetics [AEs], non-AEs, or other antimigraine [AM] regimens in adults with an acute migraine in an emergency department (ED) or headache clinic, and distinguished migraine from other types of headaches. Study quality was assessed.

Embedded ImageOutcomes:

complete relief of headache, significant reduction in headache pain (from moderate or severe to mild or none), and reduction in headache pain on the basis of a 10 …

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  • For correspondence: Dr B H Rowe, University of Alberta, Calgary, Alberta, Canada.

  • Source of Funding: Canadian Institute of Health Research and Canadian Association of Emergency Physicians Research Consortium.