Metoclopramide and Diphenhydramine: A Randomized Controlled Trial of a Treatment for Headache in Pregnancy when Acetaminophen Alone Is Ineffective (MAD Headache Study)

• DOI: 10.1055/s-0038-1646952
• Publication Date: 2018-05-03T22:57:16Z
• Authors: Christina Dothager; Jeffrey Gavard; Sara Lebovitz; Catherine Laska; Dorothea Mostello; Katherine Childress
• Keywords: Acetaminophen; Metoclopramide; Pain score

Objective We investigated whether metoclopramide administered with diphenhydramine (MAD) relieves headache in pregnant women when acetaminophen alone is ineffective, using codeine for comparison. Study Design Normotensive the second or third trimester were randomized to MAD intravenously (10 mg and 25 mg, respectively) orally (30 mg) after 650 1,000 of failed relieve their headaches. Headache severity (pain score 0–10) was noted at intervals over 24 hours. The primary outcome reduction pain 6 hours medication administration. A sample size calculation 35 patients per group based on estimated by least two points, an α 0.05 a power 80%. Results No difference seen outcome. scores lower 30 minutes (3 ± 2.8 versus 5.8 2.3, p < 0.001), 1 hour (2.2 2.3 vs. 4.1 3; 0.01), 12 (1.3 2.5 2.7 0.05), but not Time perceived relief shorter than (20.2 13.4 62.4 62.2 minutes; 0.001). More reported full within (76.5 37.5%; 0.01). Conclusion effectively headaches fails.