Migraines are a common problem that many people experience. They can be incredibly painful and disruptive to daily life. Estimates show it may affect up to 148 million people. In the U.S. alone, more than 37 million people live with this neurological condition. Like adults, children are also affected by this debilitating disease.
Migraine is a neurologic disorder that often causes a strong headache, usually on one side of the head. The headache comes in episodes and sometimes also comes with nausea, vomiting, and sensitivity to light. The good news is that there are treatments available to help manage the pain and symptoms associated with migraines.
Metoclopramide is a common drug used to treat nausea and vomiting. It works by increasing the movement of the stomach and intestines, which can help to relieve nausea and other digestive symptoms. It is also beneficial in treating acute episodes of migraine in children. Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used to treat pain and inflammation.
It works by blocking the production of certain chemicals in the body that are responsible for causing pain and inflammation. Some reports have suggested that adding ketorolac to metoclopramide may be effective for treating migraine episodes in children, but strong clinical data is lacking.
Clinical Trial
A clinical trial looked at the effectiveness of two treatment regimens for migraines in the emergency department: metoclopramide monotherapy and metoclopramide plus ketorolac combination therapy.
The clinical trial involved 53 children aged 5-17 years presenting for acute treatment of migraine headache in the emergency department. Children were randomly assigned to receive IV metoclopramide (0.2 mg/kg) and placebo or IV metoclopramide (0.2 mg/kg) and ketorolac (0.5 mg/kg).
The researchers looked at the effectiveness of each treatment in reducing the severity of migraine pain using a Visual Analog Scale (VAS).
The results of the clinical trial showed that adding ketorolac to metoclopramide did not add any significant benefit in reducing migraine pain. The average difference between the two groups was 8mm on the VAS which was not statistically significant. Additionally, there was no difference in headache recurrence or adverse events between groups.
Conclusion
Overall, the results of this clinical trial suggest that adding ketorolac to metoclopramide monotherapy in children with acute migraine episodes may not be an effective option as hypothesized earlier. It emphasizes that while metoclopramide monotherapy may be an effective therapy for migraine, the addition of ketorolac does not confer any additional benefit in these patients. It is important to work with a healthcare provider to determine the best course of treatment for each individual person based on their medical history and specific needs.
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