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Drug Combo Superior to Placebo for Posttraumatic Headache

THURSDAY, March 25, 2021 -- 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 online March 24 in Neurology.

Benjamin W. Friedman, M.D., from the Albert Einstein College of Medicine in Bronx, New York, and colleagues 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 researchers found that 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 percent 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," Friedman 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."

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