Get access

Neuroleptics in Headache


  • Hua C. Siow MD,

  • William B. Young MD,

  • Stephen D. Silberstein MD

  • From National Neuroscience Institute, Neurology, Singapore (Dr. Siow); Thomas Jefferson University, Neurology, Philadelphia, PA, USA (Drs. Young and Silberstein)

Address all correspondence to Dr. Hua C. Siow, National Neuroscience Institute, Neurology, Singapore.


Objectives.—To review the mechanism of action of neuroleptics, the evidence for their efficacy, and their clinical use in headache treatment.

Background.—Neuroleptics and antiemetics have long been used for headache treatment; however, they have not been widely utilized because of general unfamiliarity with them and concerns about their adverse events. With the recent advent of the atypical neuroleptics and their improved adverse event profile, our armamentarium for headache treatment has expanded. In this review, we explore the mechanism of action of these classes of drugs, their adverse events, and the evidence for their efficacy. We also detail our experience with the different drugs and how we use them as both acute and preventive headache therapy.

Design.—A review of published literature was obtained through a MEDLINE search on the use of neuroleptics in headache therapy.

Conclusion.—Neuroleptics have widespread evidence supporting their use in headache treatment and present an important part of the armaterium against headache.