A Bayesian network meta-analysis of 64 randomized controlled trials found that intravenous chlorpromazine provides superior pain relief for migraine patients in the emergency department at 2 hours. Combining intravenous metoclopramide with other medications was effective in avoiding the need for rescue medications. Chlorpromazine was ranked highest for pain relief at 2 hours, while the metoclopramide-ibuprofen combination was most effective at preventing the need for rescue drugs. Dexamethasone was identified as the most likely to prevent significant adverse reactions. However, there were inconsistencies in data for pain intensity changes at 1 hour, leading to unreliable results in broader settings. Further studies are needed to determine optimal treatment options for migraine in the ED.
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Which Migraine Treatments Work Best in the ED?
