This study was undertaken to compare the effectiveness and safety of three dosage levels of
butorphanol in 52 patients with acute, severe
migraine headache. After baseline evaluation, patients were given a dose of
butorphanol 1.0, 2.0, or 3.0 mg intramuscularly on a double-blind basis. Assessments of
pain intensity and
pain relief using 100 mm linear analog scales (LAS), vital signs, and medication side effects were made at 15, 30, 45, and 60 minutes after the dose. All three treatment groups were similar in baseline characteristics. Each dose of
butorphanol demonstrated a significant decrease in
pain intensity LAS compared to baseline and increase in
pain relief LAS over the observation period. The majority of
analgesic response was observed at the first (i.e., 15-min) assessment. Doses of 2.0 and 3.0 mg produced significantly greater
analgesia than did 1.0 mg at all posttreatment evaluations. No significant difference was apparent between the 2.0- and 3.0-mg doses. Adverse cardiovascular and respiratory depressant effects were not observed. An
analgesic response to
butorphanol 2.0 and 3.0 mg is clearly and rapidly evident and near maximum 30-45 minutes after administration. We conclude that in these doses
butorphanol provides effective and safe
analgesia for patients with acute
migraine headache.