Clin Exp Emerg Med.
2017 Sep;4(3):138-145. 10.15441/ceem.16.199.
Single-dose intravenous sodium valproate (Depakine) versus dexamethasone for the treatment of acute migraine headache: a double-blind randomized clinical trial
- Affiliations
-
- 1Department of Neurology, Faculty of Medicine, Immunogenetics Research Center, Clinical Research Development Unit of Bou Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran. N.karimi@mazums.ac.ir
- 2Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
- 3Departments of Biostatistics, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
- 4Bou Ali Sina Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
- KMID: 2401242
- DOI: http://doi.org/10.15441/ceem.16.199
Abstract
OBJECTIVE
Migraine headache is a chronic and disabling condition in adults. Some studies have investigated the efficacy of sodium valproate in the treatment of acute migraine, but the effectiveness and tolerability of intravenous valproate as abortive therapy remains unclear. This study aimed to evaluate the effects of sodium valproate and dexamethasone in the treatment of acute migraine.
METHODS
We conducted a double-blind randomized clinical trial including 90 patients aged 18 to 65 years with acute migraine headache but no aura. Patients were randomized to receive intravenous dexamethasone (8 mg) or sodium valproate (400 mg) diluted into 4 mL of normal saline. The primary outcome measure was pain relief after 0.5, 1, 3, or 6 hours after administration. The secondary outcome criteria were the associated symptom recovery, rate of headache recurrence after 24 hours, and medication side effects. Pearson's chi square and the t-test were employed in the data analysis.
RESULTS
Of the 90 patients, 80 were investigated. The percentage of headache improvement at 0.5 hours after treatment was 55% and 67.5% in the sodium valproate and dexamethasone groups, respectively. Before-treatment and 0.5 hour after treatment pain severity visual analog scale scores were 9.05±0.90 and 3.8±3.09 in the sodium valproate group and 8.92±0.79 and 3.10±2.73 in the dexamethasone group, respectively. There were no significant intergroup differences.
CONCLUSION
This randomized clinical trial showed that the intravenous injection of sodium valproate 400 mg has similar effects to those of dexamethasone for improving acute migraine headache.
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