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  • Paracetamol is more effective than placebo for migraine, and paracetamol 1000 mg plus metoclopramide 10 mg is similarly effective to oral sumatriptan 100 mg for migraine relief at 2 h

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Therapeutics
Systematic review
Paracetamol is more effective than placebo for migraine, and paracetamol 1000 mg plus metoclopramide 10 mg is similarly effective to oral sumatriptan 100 mg for migraine relief at 2 h
  1. Matthew S Robbins
  1. Montefiore Headache Center, Saul R Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA
  1. Correspondence to Matthew S Robbins
    Montefiore Headache Center, Saul R Korey Department of Neurology, Albert Einstein College of Medicine, 1575 Blondell Avenue, Suite 225, Bronx, NY 10461, USA; marobbin{at}montefiore.org

https://doi.org/10.1136/ebm1201

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    Commentary on: Derry S, Moore RA, McQuay HJ. Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults. Cochrane Database Syst Rev 2010;11:CD008040.

    Context

    Migraine is an extraordinarily common primary headache disorder, and the majority of sufferers rely solely on non-prescription analgesics such as paracetamol for relief. In a survey of 165 000 individuals in the USA, 68% of people with migraine reported using paracetamol for acute attacks at least monthly, and 35% of those with chronic migraine used paracetamol an average of 19 days monthly.1 Antiemetics like metoclopramide are often prescribed in combination therapy with analgesics like paracetamol.

    Methods

    Massey and colleagues systematically evaluated randomised, double-blind, placebo- or active comparator-controlled studies in which paracetamol with or without an antiemetic was used to treat acute migraine attacks. The authors identified studies by searching Cochrane CENTRAL, MEDLINE, EMBASE, the Oxford Pain Relief Database and online clinical trial registries. Other inclusion criteria were age ≥18 years, ≥10 participants per treatment arm and a migraine diagnosis by International Headache Society criteria or another closely resembling definition.

    Patients were not excluded based on …

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    Footnotes

    • Competing interests None.