Skip Opioid Treatment for Migraine in the ER

Skip Opioid Treatment for Migraine in the ER

For people seeking treatment for a migraine in the emergency room, a commonly prescribed opioid called hydromorphone (Dilaudid or Exalgo) doesn't seem to work as well as at least one other medication, a new study finds.

Mental Health Does Not Come With A Manual, It Comes With Friends & Family Support That Never Gives Up!
Join now

"People go to U.S. emergency departments 1.2 million times a year with migraine, and the opioid drug hydromorphone is used in 25 percent of these visits, yet there have been no randomized, high-quality studies on its use for acute migraine," said study author Dr. Benjamin Friedman. He is with the department of emergency medicine at the Albert Einstein College of Medicine in New York City.

Doctors should consider available alternatives before giving patients the opioid painkiller, the study authors suggested in a news release from the American Academy of Neurology.

For the study, researchers investigated if opioid use led to addiction among 127 patients who made repeated trips to two emergency departments in New York for treatment of migraines.

Half of the people were treated with hydromorphone. The remaining patients were given prochlorperazine through an IV. This drug works by blocking the release of a brain chemical called dopamine.

The researchers looked at how many of the patients had migraine relief for at least 48 hours. The study was halted after the 127 patients were enrolled because the results showed that prochlorperazine worked dramatically better than hydromorphone.

After 48 hours, 60 percent of the patients on prochlorperazine had prolonged headache relief, compared with 31 percent of the people treated with hydromorphone. In the emergency room, 31 percent of those who received hydromorphone asked for a second dose of the drug. The same was true for only 8 percent of those who received prochlorperazine.

Of the patients on hydromorphone, 36 percent asked for other painkillers, compared with only 6 percent of the prochlorperazine group, according to the report.

There was no difference in how often the patients from both treatment groups returned to the ER due to a migraine within one month of the treatment, the researchers pointed out.

Friedman noted that patients who had used opioids within the past 30 days or had a history of addiction to these drugs were excluded from the study. Therefore, the study participants may have been at lower risk for an opioid abuse problem than people in the general population.

"While this study demonstrates the overwhelming superiority of prochlorperazine over hydromorphone for initial treatment of acute migraine, the results do not suggest that treatment with IV opioids leads to long-term addiction," Friedman said.

The Internet's Most Trusted Source For Mental Health Information
Sign up

"In addition, the results should not be used to avoid the use of opioids for people who have not responded well to anti-dopaminergic drugs [such as prochlorperazine]," he added.

The study was published online Oct. 18 in the journal Neurology.

More information

The U.S. National Library of Medicine has more about the opioid hydromorphone.


Copyright © 2013-2017 HealthDay. All rights reserved.


Related Content

Addiction To Cocaine Sees Promising Cure In Near Future In Preventing Overdose
Addiction To Cocaine Sees Promising Cure In Near Future In Preventing Overdose

A radical gene therapy for drug addiction has been shown to dampen down cravings...

Read more
How Therapy Dogs Are Providing Significant Benefits To Children With ADHD
How Therapy Dogs Are Providing Significant Benefits To Children With ADHD

For children struggling with attention-deficit hyperactivity disorder (ADHD), vi...

Read more
The 4 Mistakes People With Anxiety Make & How To Prevent Them From Happening
The 4 Mistakes People With Anxiety Make & How To Prevent Them From Happening

I recently wrote a well-received post about five mistakes that people with depre...

Read more
Did You Know That 20% Autism Patients Were ALSO Diagnosed With Depression?
Did You Know That 20% Autism Patients Were ALSO Diagnosed With Depression?

Almost 20% of young people with autism spectrum disorder (ASD) also were diagnos...

Read more
Is There Anyone Else Out There With Bipolar Disorder & OCD Symptoms?
Is There Anyone Else Out There With Bipolar Disorder & OCD Symptoms?

It's not at all uncommon that I hear obsessive-compulsive (OC) symptoms as part ...

Read more
Signs Your Parent May Actually Have A Personality Disorder & How To...
Signs Your Parent May Actually Have A Personality Disorder & How To...

Have you always struggled in your relationship with your parent? Maybe your rela...

Read more