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Critical reappraisal of intravenous metoclopramide in migraine attack: a systematic review and meta-analysis.

Abstract
Migraine is one of the most common causes of headache presentations to emergency departments (EDs). Patients with migraine attack need rapid pain relief rather than diagnostic modalities. Metoclopramide, a dopamine antagonist with a primary use of antiemetic, has been used commonly in ceasing migraine attack. An earlier meta-analysis favors metoclopramide over placebo but includes studies with significant methodological errors and heterogeneity. The present article aimed to review the literature to reveal studies comparing metoclopramide to either placebo or active comparators. A literature search including PubMed, Cochrane Database, and Google Scholar was performed by using the evidence-based process for determining the study quality. Although the studies comparing parenteral metoclopramide to placebo in ceasing migraine headache favor metoclopramide to placebo and lower rates of rescue drug need, however, they lack high methodological quality even to perform a meta-analysis. Meanwhile, the effect of metoclopramide in ceasing migraine headache is also comparable to active comparators. It seems reasonable to use metoclopramide in migraine attacks in EDs according to the current literature. However, further studies with high methodological quality are needed to reveal whether and how much metoclopramide is superior to placebo.
AuthorsCenker Eken
JournalThe American journal of emergency medicine (Am J Emerg Med) Vol. 33 Issue 3 Pg. 331-7 (Mar 2015) ISSN: 1532-8171 [Electronic] United States
PMID25579820 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
CopyrightCopyright © 2014 Elsevier Inc. All rights reserved.
Chemical References
  • Antiemetics
  • Metoclopramide
Topics
  • Administration, Intravenous
  • Antiemetics (therapeutic use)
  • Emergency Service, Hospital
  • Humans
  • Metoclopramide (therapeutic use)
  • Migraine Disorders (drug therapy)
  • Treatment Outcome

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