Intravenous Chlorpromazine - Preliminary Results In Acute Migraine

Authors

  • RL. Lane M.D.,

  • R. Ross M.D.


Abstract

SYNOPSIS

Acute migraine headache is a common presentation in the Emergency Department. Patients have usually taken a variety of prescription and non-prescription medications prior to presentation - narcotics, ergotamine preparations, etc. Because of the side effects and addictive potential of narcotics, an alternative was sought. Because of some theoretical attractions and encouraging early results, intravenous chlorpromazine (CPZ) was used, in small bolus injections into an established line. A retrospective analysis was conducted. This involved 40 patients, and a total of 52 emergency department visits, with a discharge diagnosis of migraine. Dose of CPZ required varied from 5–50 mg., with a mean of 21.7 mg. The therapy was completely effective on 38/52 occasions, left very mild residual headache on 11/52 occasions, and provided only mild relief on the other 3/52 occasions. Adverse effects were minimal, with most patients reporting some drowsiness and 10/52 patients reporting symptoms of hypotension. This cleared with bedrest and a short bolus of IV fluids. This degree of efficacy would appear superior to the alternative modes of therapy available, although few reports exist. It is concluded that a controlled trial is needed to fully establish this new mode of therapy.

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