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Parenteral Metoclopramide for Acute
Migraine: meta-analysis of randomized controlled trials
Colman I, Brown MD, Innes GD, et al.
Posted: January 2006  
BMJ 2004;329;1369-1373

Objective:   To assess the evidence from controlled trials on the efficacy and tolerability of parenteral metoclopramide for acute migraine in adults.

Selection Criteria:   Randomized controlled trials of parenteral metoclopramide for acute migraine in adults.

Results:  We reviewed 596 potentially relevant abstracts and found 13 eligible trials totaling 655 adults. In studies comparing metoclopramide with placebo, metoclopramide was more likely to provide significant reduction in migraine pain. Used as the only agent, metoclopramide showed mixed effectiveness when compared with other single agents.

Conclusions:  Metoclopramide is an effective treatment for migraine headache and may be effective when combined with other treatments. Given its non-narcotic and antiemetic properties, metoclopramide should be considered a primary agent in the treatment of acute migraines in emergency departments.