We retrospectively analyzed the data of inpatients with refractory
chronic daily headache who received intravenous repetitive
prochlorperazine treatment from November 1996 to March 1999. A semistructured telephone follow-up interview was done in September 1999.
RESULTS: A total of 135 patients (44 men, 91 women) were recruited, including 95 (70%) with
analgesic overuse. After intravenous
prochlorperazine treatment, 121 (90%) achieved a 50% or greater reduction of
headache intensity, including 85 (63%) who became
headache-free. The mean
hospital stay was 6.2 +/- 2.7 days, and mean total
prochlorperazine used was 98 +/- 48 mg. Acute extrapyramidal symptoms occurred in 21 patients (16%). One hundred twenty-four patients (92%) were successfully followed up, with a mean duration of 14.3 +/- 7.5 months. Compared with pretreatment status, 93 patients (75%) considered their
headache intensity decreased, and 86 patients (69%) considered their
headache frequency decreased, although 40 (32%) still had a daily
headache. Of the 87 patients with
analgesic overuse who could be followed, 61 (70%) no longer overused
analgesics. Poor response to
prochlorperazine treatment (relative risk, 1.8) and presence of major depression (relative risk, 1.8) were predictors of persistent
chronic daily headache at follow-up.
CONCLUSIONS: