- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Migraine attacks can be successfully aborted with IV Metoclopramide
New research revealed that intravenous application of 10mg Metoclopramide was effective and successful in relieving migraine attacks with minimal side effects. Its efficacy was much higher than placebo and sumatriptan while lower than only granisetron. It also could completely relieve headaches and decrease the need for rescue medication much better than a placebo and valproate. The study was published in the journal BMC Neurology.
Often accompanied by nausea, vomiting, and extreme sensitivity to light, sound, and smell, migraine is a complex disorder of a neurovascular nature that is characterized by a severe throbbing, pulsatile pain that is localized to one side of the brain or the cerebral cortex or the brain stem and has a high propensity to recur. Metoclopramide, a central dopamine receptor blocker with peripheral muscarinic agonistic action [6] and anti-emetic properties, is frequently recommended as a reliable option for reducing discomfort and nausea and is thus recognized as an efficient single drug for the treatment of migraine in ED. Many drugs are prescribed in relieving acute migraine attacks, hence researchers conducted a systematic review and network meta-analysis to compare metoclopramide with other antimigraine drugs.
Databases like PubMed, Cochrane Library, Scopus, and Web of Science were searched till June 2022 for RCTs that compared metoclopramide alone with placebo or active drugs. The main outcomes were the mean change in headache score and complete headache relief. The secondary outcomes were the rescue medications need, side effects, nausea, and recurrence rate. Outcomes were qualitatively reviewed and the network meta-analyses (NMAs) were carried out which were done by the Frequentist method using the MetaInsight online software.
Key findings:
- Sixteen studies were included with a total of 1934 patients where 826 received metoclopramide, 302 received placebo, and 806 received other active drugs.
- Metoclopramide effectively reduced headaches even for 24 h.
- The intravenous route was the most chosen route and significant positive results were seen regarding headache outcomes. But the best route was not compared in the previous studies.
- Headache outcomes were effectively improved by both 10 and 20 mg doses of metoclopramide and 10 mg dose was the most frequently used dosage however, there was no direct comparison between both doses.
- In NMA of headache change after 30 min or 1 h, metoclopramide effect came after granisetron, ketorolac, chlorpromazine, and Dexketoprofen trometamol.
- Only granisetron’s effect was significantly higher than metoclopramide’s effect which was only significantly higher than placebo and sumatriptan.
- In headache-free symptoms, only prochlorperazine was non-significantly higher than metoclopramide which was higher than other medications and showed significantly higher effects only with a placebo.
- In rescue medication, metoclopramide’s effect was only non-significantly lower than prochlorperazine and chlorpromazine while its effect was higher than other drugs and showed higher significant effects only than placebo and valproate.
- In the recurrence rate, studies showed no significant difference between metoclopramide and other drugs.
- Metoclopramide significantly decreased nausea more than the placebo.
- Regarding side effects, metoclopramide showed a lower incidence of mild side effects than pethidine and chlorpromazine and showed a higher incidence of mild side effects than placebo, Dexamethasone, and Ketorolac.
- The reported extrapyramidal symptoms with Metoclopramide were dystonia or akathisia.
Thus, this is the first-ever study to perform a comprehensive review and network meta-analyses on the effect of metoclopramide in reducing acute migraine attacks compared to other anti-migraine drugs.
Further reading: Abdelmonem, H., Abdelhay, H.M., Abdelwadoud, G.T. et al. The efficacy and safety of metoclopramide in relieving acute migraine attacks compared with other anti-migraine drugs: a systematic review and network meta-analysis of randomized controlled trials. BMC Neurol 23, 221 (2023).https://doi.org/10.1186/s12883-023-03259-7
BDS, MDS
Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751