Sodium Valproate Versus Dopamine Antagonists for Acute Migraine in the Emergency Department: A Systematic Review
العنوان: | Sodium Valproate Versus Dopamine Antagonists for Acute Migraine in the Emergency Department: A Systematic Review |
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المؤلفون: | J Alexander Viau, Miguel A Cortel-LeBlanc, Jeffrey J. Perry, Avik Nath, Dilan Patel, Wei Cheng |
المصدر: | Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques. 49:688-695 |
بيانات النشر: | Cambridge University Press (CUP), 2021. |
سنة النشر: | 2021 |
مصطلحات موضوعية: | Adult, Acute migraine, business.industry, Migraine Disorders, Valproic Acid, Sodium, MEDLINE, Pain, chemistry.chemical_element, General Medicine, Pharmacology, Neurology, chemistry, Dopamine, Dopamine Antagonists, Humans, Medicine, Neurology (clinical), Emergency Service, Hospital, business, medicine.drug |
الوصف: | Background:Migraine is a common primary headache disorder diagnosed in the emergency department (ED). This systematic review sought to compare the efficacy of sodium valproate (SV) to dopamine antagonists (DA) in relieving pain due to acute migraine.Methods:Two research librarians helped create a search strategy including Embase, Ovid Medline, and the Cochrane Database of Clinical Trials from inception to June 1, 2020, updated May 19, 2021. Two investigators identified randomized control trials (RCTs) including adult patients with acute migraine presenting to the ED or acute clinical setting comparing SV to a DA with the aim of relieving pain. Primary outcome was headache relief at 1 hour from treatment. Secondary outcomes included pain relief at 24 hours, relief of associated symptoms (e.g. nausea, photo-/phonophobia, etc.), and need for rescue analgesia. Meta-analysis was performed and presented as odds ratios.Results:Four RCTs with 470 patients were identified from an initial pool of 454 titles. Two studies compared SV to a DA alone and two compared SV to a DA plus one other agent (sumatriptan or dihydroergotamine). Three studies were included for meta-analysis. Pain relief had a pooled odds ratio of 1.14 at 1 hour and 0.42 at 24 hours. Three articles reporting the need for rescue analgesia had pooled odds ratio of 2.76.Conclusions:Sodium valproate is not more effective than DA at reducing migraine headache pain at 1 hour and less effective at 24 hours. Dopamine antagonists should be used over SV for the management of patients with acute migraine. |
تدمد: | 2057-0155 0317-1671 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6e378e6c79f9ce15233c3a680df93367 https://doi.org/10.1017/cjn.2021.195 |
حقوق: | CLOSED |
رقم الأكسشن: | edsair.doi.dedup.....6e378e6c79f9ce15233c3a680df93367 |
قاعدة البيانات: | OpenAIRE |
تدمد: | 20570155 03171671 |
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