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Intravenous chlorpromazine for acute paediatric migraine

Ruth Mc Löllgen1,2,3,4, Franz E Babl1,2,5, Mark T Mackay2,5,6

  • 1Emergency Department, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.

Emergency Medicine Australasia : EMA
|June 10, 2022
PubMed

Insights

Second-line emergency treatment for pediatric migraine using intravenous chlorpromazine showed safety but unclear effectiveness. Further research is needed to optimize pain management for children experiencing severe migraine attacks.

Area of Science:

  • Pediatric Emergency Medicine
  • Neurology
  • Clinical Pharmacology

Background:

  • Established first-line treatments for pediatric migraine include ibuprofen, acetaminophen, and triptans.
  • Limited data exists on the efficacy and safety of second-line emergency treatments for pediatric migraine.

Purpose of the Study:

  • To evaluate the safety and efficacy of intravenous chlorpromazine as a second-line emergency treatment for pediatric migraine.

Main Methods:

  • Retrospective cohort study conducted in a tertiary children's hospital emergency department.
  • Analysis of 207 children diagnosed with migraine over a one-year period.
  • Review of treatment protocols, including simple oral analgesia and intravenous chlorpromazine administration.

Main Results:

  • 46% of pediatric migraine patients received simple oral analgesia.
  • 25% of patients received intravenous chlorpromazine, with 45% requiring additional analgesia.
  • Intravenous chlorpromazine was generally safe but its efficacy was questionable due to the need for further treatment.

Conclusions:

  • Intravenous chlorpromazine may be a safe option for second-line treatment in pediatric migraine.
  • The efficacy of intravenous chlorpromazine is uncertain, as many patients required subsequent treatments.
  • Further investigation is warranted to establish optimal second-line therapeutic strategies for pediatric migraine in emergency settings.
Abstract

Keywords:
childchlorpromazineemergency serviceheadachemigraine disorder

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