Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Jul 20, 2022; 12(4): 319-330
Published online Jul 20, 2022. doi: 10.5662/wjm.v12.i4.319
Pain reduction and adverse effects of intravenous metoclopramide for acute migraine attack: A systematic review and meta-analysis of randomized-controlled trials
Nat Ungrungseesopon, Wachira Wongtanasarasin
Nat Ungrungseesopon, Wachira Wongtanasarasin, Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
Wachira Wongtanasarasin, Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA 95817, USA
Author contributions: Ungrungseesopon N and Wongtanasarasin W designed the protocol, contributed to data collection and analysis, and wrote the first draft of the manuscript; Wongtanasarasin W edited and revised the manuscript; both authors read and critically reviewed the final version of the manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2021 Checklist, and the manuscript was prepared and revised according to the PRISMA 2021 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wachira Wongtanasarasin, MD, Attending Doctor, Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, 110 Intavarorot Street, Sriphum, Chiang Mai 50200, Thailand. wachir_w@hotmail.com
Received: February 4, 2022
Peer-review started: February 4, 2022
First decision: April 11, 2022
Revised: April 26, 2022
Accepted: July 11, 2022
Article in press: July 11, 2022
Published online: July 20, 2022
Processing time: 165 Days and 12.9 Hours
ARTICLE HIGHLIGHTS
Research background

Metoclopramide may be used to treat people suffering from acute migraine. However, no comprehensive investigation on this issue has been recorded. This review will provide more solid evidence for the use of metoclopramide in treating acute migraine.

Research motivation

Metoclopramide was considered the “probably effective drug”, even though several studies showed the efficacy of metoclopramide monotherapy. It has been investigated that the efficacy of metoclopramide was neither inferior to sumatriptan nor opioid. Moreover, apart from the efficacy aspect, metoclopramide showed superiority in other aspects, such as lower adverse severe effects and lower addiction rates.

Research objectives

The objective of this review was to investigate the efficacy of intravenous metoclopramide with other therapies in migraine attack treatment in an emergency department (ED).

Research methods

We conducted a systematic review and meta-analysis of randomized controlled trials.

Research results

The administration of received intravenous metoclopramide was an effective treatment for migraine headache in adults, compared with placebo. However, the benefit of metoclopramide was not superior to other drugs.

Research conclusions

Metoclopramide is more effective than placebo in treating migraine in the ED. Although its effectiveness was not observed on other medications, clinicians may select metoclopramide as one of the first line treatments for acute migraine.

Research perspectives

Despite the observed tendency of decreased side effects, the effectiveness of metoclopramide compared to other regimens is poorly understood. More research on this area is needed to treat migraine in acute care settings effectively.