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Background: In this double-blinded, randomized trial, we hypothesized that propofol is as effective as sumatriptan in treating acute migraine headaches, with better control of nausea and vomiting, and fewer side effects., Methods: Ninety cases of acute migraine attack admitted to the emergency department were randomly allocated into two treatment groups: (1) 6 mg of sumatriptan subcutaneously or (2) propofol injected intravenously in 30 to 40 mg boluses, followed by 10 to 20 mg intermittent bolus doses to sedate the patients to Ramsey score of 3 to 4. Headache severity was assessed using an 11-point visual analog scale before treatment and 30 minutes, 1 hour, and 2 hours after treatment. Accompanying symptoms, improvement in headache, and the need for anti-emetic therapy were also assessed., Results: A total of 91 patients were enrolled in this study. One patient in the sumatriptan group was excluded due to severe chest tightness, and 90 patients were included in the final analysis. Pain intensity was significantly lower in the propofol group 30 minutes after treatment (P = 0.001); however, after 1 and 2 hours, there were no significant differences between the groups. The need for anti-emetic therapy and the recurrence of symptoms were significantly lower in the propofol group (P = 0.045 and P = 0.001, respectively)., Conclusion: Propofol is equally suitable as sumatriptan for the acute treatment of migraine headaches in an emergency department setting. Moreover, the use of propofol avoids some of the adverse side effects of sumatriptan while providing better control of nausea and vomiting., (© 2014 World Institute of Pain.)

Background: Sodium valproate (SV) has been approved for migraine prophylaxis and its intravenous form is used to treat acute migraine attacks. We compared the efficacy and safety of intravenous SV and subcutaneous Sumatriptan in managing acute migraine attacks. Methods: This double-blind randomized clinical trial divided 90 patients into two groups: one group received 400 mg of intravenous SV and the second group received 6 mg of subcutaneous Sumatriptan. Headache severity before treatment and half an hour, one hour, and two hours after treatment was measured based on the VNRS in the groups. Associated symptoms, i.e., photophobia, phonophobia, nausea, and vomiting, were assayed on admission and 2 hours after treatment. Side effects of the drugs were checked 2 hours after injection. Obtained data from the groups were compared. Results: In both groups, pain decrement at the mentioned time points was significant (P<0.001), but had no significant difference (P>0.05), indicating the similar effect of both drugs on pain improvement. In the SV group, photophobia, phonophobia, nausea, and vomiting were improved significantly, while in the Sumatriptan group, only photophobia and vomiting were decreased significantly, indicating the advantage of SV in improving the associated symptoms. Nausea, vomiting, facial paresthesia, and hypotension were more significantly frequent in the Sumatriptan group than in the SV group (P<0.05). Conclusion: Intravenous SV (400 mg) was as effective as subcutaneous Sumatriptan in the treatment of acute migraine attacks, but with more improvement in associated symptoms and with fewer side effects. [ABSTRACT FROM AUTHOR]