For patients with acute posttraumatic headache presenting to the emergency department, intravenous metoclopramide + diphenhydramine (M+D) is more efficacious than placebo, according to a study published in Neurology. Researchers randomly assigned 160 participants who experienced head trauma and presented to the emergency department within 10 days with a headache to either M+D or placebo in a double-blind trial. Overall, 81 and 79 participants were assigned to M+D and placebo, respectively. The mean improvement in pain was 5.2 for participants receiving M+D, compared with 3.8 for placebo participants (difference of 1.4 favoring M+D). Adverse events were reported by 43% and 28% of patients receiving M+D and placebo, respectively. “More research is needed to determine the most effective dose of metoclopramide, and how long to administer it, to see if people can get longer-term relief after they leave the emergency room,” a coauthor said in a statement. “Also, future work may be able to determine whether early treatment with this medication can target other disruptive symptoms you may get after a head injury, like depression, sleep disorders, and anxiety.”
