Efficacy of intravenous dexamethasone in treatment of acute migraine headache: a randomized clinical trial running title

ABSTRACT

Migraine is characterized by unilateral and pulsatile headache with or without aura. There are various treatments of migraine attack. One of them is intravenous [IV] Corticosteroids which is used in status migrainous. The aim of this study is comparison of the efficacy of I.V Dexamethasone with intramuscular [I.M] Methadone in improvement of migraine attacks. This study was a controlled double- blind randomized clinical trial on all patients whom referred to emergency room with diagnosis of migraine attack. The patients were randomized in four groups. Groups I and II received intravenous 8 mg Dexamethasone, while groups III and IV received intramuscular 10 mg Methadone. Thereafter all of them were evaluated after 2, 4 and 6 hours. One-hundred and eighty one patients were evaluated; 107 patients were treated with IV Dexamethasone and 74 patients with IM Methadone. One-hundred and three of 107 patients [96.2%] had complete or significant improvement whereas 63 of 74 patients [85%] whom received IM Methadone had similar improvement [P= 0.01]. Our study showed that treatment of acute migraine headache by using intravenous Dexamethasone is more effective than Methadone