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Intravenous Sodium Valproate vs. Prochlorperazine
for the Emergency Department Treatment of
Acute Migraine Headaches: A Prospective, Randomized,
Double-Blind Trial
Tanen DA, Miller S, French T, Riffenburgh RH
Posted: February 2004  
Ann Emerg Med. 2003;41:847-853

Study Objective:   We compare the efficacy of intravenous sodium valproate versus prochlorperazine for the emergency department treatment of acute migraine headache.

Methods:   We performed a randomized, prospective, double-blind trial performed at a tertiary care military ED. Forty patients, aged 18 to 65 years, presenting with typical migraine symptoms were enrolled. Patients were randomized to receive either 10 mg. of prochlorperazine or 500 mg. of valproate intravenously over 2 minutes. Pain, nausea, and sedation were assessed by using a standard visual analog scale (VAS). Changes in VAS scores were compared between groups from baseline to end point by using a rank sum test, over time by using 2-way repeated-measures analysis of variance, and by requirement for rescue at 60 minutes by using the Fisher exact test.

Conclusion:   Prochlorperazine was statistically and clinically superior to sodium valproate for the treatment of the pain and nausea associated with acute migraine headaches.