Metoclopramide versus sumatriptan for treatment of migraine headache: A randomized clinical trial

There are different options to manage benign headache in the emergency department. The costs, side effects, and efficacies of the drugs used are significantly different. The aim of this study was to compare intravenous (IV) metoclopramide with subcutaneous (SC) sumatriptan in treatment of migraine headache.

In a randomized, double-blinded clinical trial study, patients presenting to the university referral emergency department with acute benign headache were allocated into two groups after obtaining their informed consent. Patients received 20 mg of IV metoclopramide or 6 mg of SC sumatriptan. Pain intensity was assessed with 10-cm visual analog scale at baseline and 60 min after treatment.

One hundred and twenty-four subjects participated. The mean age was 34.9 ± 9 years in metoclopramide group and 26.8 ± 4 years in sumatriptan group (P < 0.0001). The baseline pain scores were 6.47 ± 0.84 and 6.12 ± 0.73 in metoclopramide and sumatriptan groups, respectively (P < 0.0001). The mean of pain score decreased to 0.66 ± 0.59 cm (P < 0.0001) in the metoclopramide group and 1.1 ± 0.70 (P < 0.0001) in the sumatriptan group. Comparison of these two groups showed more pain reduction in the metoclopramide group, with a mean difference of 0.55 ± 0.13 between the groups (95% CI: 0.25-0.79 cm) (P < 0.0001).

For treatment of migraine headache, IV metoclopramide may be superior to SC sumatriptan in the emergency department.