Treatment of migraine with intramuscular chlorpromazine.

We undertook a prospective, randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of intramuscular parenteral chlorpromazine (CPZ) in the treatment of the acute migraine attack. Thirty-six patients who presented to the emergency department with migraine headache were given either CPZ (1 mg/kg) or a saline placebo and were observed for one hour. Of those receiving CPZ, nine of 19 (47.4%) had sufficient relief from their headache to carry on with their activities of daily living, compared with four of 17 (23.5%) of the control group. This difference was not statistically significant. However, the drug was more often effective than a placebo in giving some relief from the headache (P less than .005) and in relieving nausea significantly more often than placebo (P less than .001). The only significant side effects were drowsiness (P less than .01), and an asymptomatic drop in blood pressure (10 mm Hg systolic) (P less than .05). This controlled study demonstrates that CPZ is a safe medication that provides some relief from migraine headaches, but it is less efficacious than suggested in earlier reports.

A relationship between ultrasonic intensity and changes in myocardial mechanics.

The effects of ultrasound on the mechanical properties of isometrically contracting rat papillary muscle have been studied as a function of the intensity of the ultrasonic irradiation. Each muscle was subjected to irradiation at 1.1., 2.2, and 3.3 W/cm2 at a frequency of 2.3 MHz. Ultrasonic irradiation caused heating in the vicinity of the muscle; thus it was necessary to separate the pure thermal and ultrasonic effects. After irradiation the bath temperature was increased so that the muscle reached the same temperature which occurred during ultrasonic irradiation. The mechanical parameters measured during the equivalent thermal procedure were compared with the parameters during irradiation. There was a significant (p less than 0.05) decrease in resting force which was significantly different from the equivalent thermal intervention and could be related to the ultrasonic intensity. Thus, the effect of ultrasound on rat papillary consists of two components, a thermal component which affects all parameters studied and a nonthermal component which affects only the diastolic force.