Is Droperidol an Effective Treatment for Acute Migraine Headache?

the MPR take:

Droperidol had been used commonly as an antiemetic and a migraine headache treatment up until 2001, when the FDA issued a black box warning stating the drug could put patients at increased risk of cardiac events including QT prolongation. Some clinicians questioned the new warning, believing that the incidents that led to its addition were tied to events where droperidol was used at high doses.  Given that many of the parenteral agents used in the emergency department setting to treat acute migraine headache (eg, dihydroergotamine, ketorolac, metoclopramide, prochlorperazine, promethazine, opiates) have been at one point or another in short supply, researchers are looking once again at droperidol to see if the benefits of the drug outweigh the potential risks. In an article published in the journal Annals of Pharmacotherapy, the authors review five studies that involve the use of droperidol in the treatment of acute migraine headache. In these studies, droperidol was shown to be at least as effective as comparator drugs (eg, prochlorperazine, meperidine, olanzapine) and to be better than placebo in producing rapid pain relief from headache. The most commonly reported side effects included sedation and extrapyramidal symptoms; cardiac effects were not reported in these studies and are believed to be dose-related. The authors conclude that parenteral droperidol can be considered an effective option for acute migraine headache, but clinicians should be aware of the potential cardiac risks and should monitor patients for adverse events if the drug is used.

To evaluate the safety and efficacy of droperidol for the relief of acute migraine headaches.

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