The use of intramuscular
droperidol to treat acute
migraine headache has not been previously reported in the emergency medicine literature. It is a promising
therapy for
migraine. The authors performed a pilot review of all patients receiving
droperidol for
migraine in our emergency department (ED) to evaluate its efficacy. We used a retrospective case series, in a suburban ED with an annual patient census of 48,000. All patients with a discharge diagnosis of
migraine headache who were treated with i.m.
droperidol during a consecutive 5-month period in our ED were identified. All patients received
droperidol 2.5 mg intramuscular. As per ED protocol, their clinical progress was closely followed and documented at 30 minutes after
drug administration (t30). Demographic and clinical variables were recorded on a standardized, closed-question, data collection instrument. The primary outcome measurement was relief of symptoms at t30 to the point that the patient felt well enough to go home without further ED intervention (symptomatic relief). Thirty-seven patients were treated (84% female), with an ED diagnosis of acute
migraine with
droperidol during the study period. The mean age was 36 +/- 12 years.
Analgesics had been used within 24 hours before ED presentation by 62% of patients. At t30, 30 (81%) patients had symptomatic relief, 2 (5%) felt partial relief but required rescue medication, and 5 (14%) had no relief of symptoms. Drowsiness (14%) and mild
akathisia (8%) were the only adverse reactions observed following
drug administration.
Droperidol 2.5 mg intramuscular may be a safe and effective
therapy for the ED management of acute
migraine headache. Randomized, controlled trials are warranted to further validate the findings of this preliminary study.