Intravenous chlorpromazine versus intramuscular sumatriptan for acute migraine

To establish whether there is any difference in the efficacy of a chlorpromazine regimen and a sumatriptan regimen for the management of the pain of acute severe migraine.

Two urban teaching hospital emergency departments.

Prospective, randomised, unblinded, crossover trial. All patients received intravenous metoclopramide 10 mg and 1000 ml of normal saline over 1 h; 20 were then randomised to receive intramuscular sumatriptan 6 mg and 23 to receive intravenous chlorpromazine, 12.5 mg increments to a maximum of 37.5 mg. Response to treatment was measured using visual analogue pain scales.

No difference in efficacy between the sumatriptan regimen and the chlorpromazine regimen was found. Adverse effects were mild and equally distributed between the groups.

The chlorpromazine and sumatriptan regimens studied are both very effective for the relief of the headache of severe migraine.