Due to idiosyncratic effects of
available treatment agents, the management of acute migraine episodes should be
individualized on case to case basis.
A recent prospective quasi-experimental study published in the Korean Journal of Pain suggested that both intravenous caffeine and magnesium sulfate are effective in reducing the severity of migraine pain.
Migraine is characterised by throbbing, unilateral pain in the head along with vomiting, nausea, phonophobia, and photophobia. The evidence demonstrates that intravenous magnesium sulfate might be useful in reducing pain in migraine. Intravenous caffeine was also effective in decreasing the severity of migraine headache, as suggested by results of a pilot study.
Baratloo, et al conducted a study
which aimed to investigate the efficacy of magnesium sulfate vs intravenous
caffeine citrate for management of acute headache. The study conducted a quasi-experimental
survey in two academic medical centres of Shahid Beheshti University of Medical
Sciences (Tehran), Iran from January until May 2016. The patients admitted to
the emergency department and those who met the migraine diagnosis criteria as defined
by the International Headache Society were included. Patients were assigned to
2 groups: One group was administered with 2 g intravenous magnesium sulfate and
the second group was administered with 60 mg intravenous caffeine. Pain scores
were determined using the visual analogue scale (VAS) at baseline and one to
two hours after administering the drug. To analyse the baseline characteristics
Chi-Square test and student t-test were used. Wilcoxon signed-rank test and
Mann-Whitney U test were used to evaluate differences in the visual analogue
scale (VAS) score between and within the section consequently. A total of 70
patients (35 patients in each section) with the mean age of 33.1 ± 11.3 years
were involved, 64.3% women.
The results indicated a significant
reduction in median pain scores after 1 and 2 hours of administration in both
the Magnesium and Caffeine citrate group. However, the reduction in VAS pain
score was more significant in the magnesium sulfate group than the Caffeine
citrate group after one and two hours of administration. The study findings
suggested that both intravenous caffeine and magnesium sulfate exhibits the
potential to reduce headache severity, however, magnesium sulfate is more
effective for short-term treatment of migraine headache in ED patients.
Korean J Pain. 2017 Jul;30(3):176-182.
Intravenous caffeine citrate vs. magnesium sulfate for reducing pain in patients with acute migraine headache; a prospective quasi-experimental study.
Alireza; B. et al.
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