Hydromorphone Versus Prochlorperazine + Diphenhydramine for Acute Migraine
Hydromorphone Versus Prochlorperazine + Diphenhydramine for Treatment of Acute Migraine. A Randomized, Emergency Department Based, Comparative Efficacy Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
New York
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Bronx, New York, United States, 10461
- Montefiore Medical Center--Einstein
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Migraine headache (International Classification of Headache Disorders 3B criteria)
Exclusion Criteria:
- Brain imaging ordered
- Fever
- Objective neurological findings
- Pregnancy/ breast feeding
- Allergy/ contraindication to investigational medication
- History of addiction to opioids, use of methadone, any use of opioids previous 30 days
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Hydromorphone
Hydromorphone 1mg, administered as intravenous drip over 5 minutes.
Patients can receive second 1mg dose at 1 hour.
|
Other Names:
|
|
Active Comparator: Prochlorperazine
Prochlorperazine 10mg, administered as intravenous drip over 5 minutes. Diphenhydramine 25mg co-administered. Patients can receive second 10mg dose at 1 hour. |
Other Names:
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Sustained Headache Relief Assessed by Self-evaluation
Time Frame: up to 2 hours in Emergency Department, 48 hours after discharge from Emergency Department
|
Sustained headache relief is defined as achieving a headache level of "mild" or "none" within two hours and maintaining a level of "mild" or "none" for 48 hours, without use of addition medication.
Patient self-evaluated pain level is solicited every half hour for two hours in the Emergency Department and then by telephone 48 hours after medication administration.
|
up to 2 hours in Emergency Department, 48 hours after discharge from Emergency Department
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants Needing Rescue Medication as Assessed by Questionnaire
Time Frame: 48 hours after discharge from Emergency Department
|
Data collected by telephone.
Patients were asked if they needed additional medication after discharge in order to reduce level of pain.
This additional medication is considered rescue medication.
|
48 hours after discharge from Emergency Department
|
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Number of Participants Who Achieved Short Term Headache Relief, Assessed by Telphone Questionnaire
Time Frame: 48 hours after discharge from Emergency Department
|
Participants were asked to make evaluation of pain status since discharge.
Those achieving headache level "mild" or "none" for 1 hour are considered to achieve short term headache relief.
|
48 hours after discharge from Emergency Department
|
|
Number of Participants Who Achieved Short Term Headache Freedom; Assessed by Telephone Questionnaire
Time Frame: 48 hours after discharge from Emergency Department
|
Participants were asked to evaluate pain status since discharge.
Participants who achieved total headache freedom for at least 1 hour are considered to achieve short term headache relief.
|
48 hours after discharge from Emergency Department
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Benjamin W Friedman, MD, MS, Albert Einstein College of Medicine
Publications and helpful links
General Publications
- Cohen F, Friedman BW. A randomized study of IV prochlorperazine plus diphenhydramine versus IV hydromorphone for migraine-associated symptoms: A post hoc analysis. Headache. 2021 Sep;61(8):1227-1233. doi: 10.1111/head.14185. Epub 2021 Aug 7.
- Friedman BW, Irizarry E, Solorzano C, Latev A, Rosa K, Zias E, Vinson DR, Bijur PE, Gallagher EJ. Randomized study of IV prochlorperazine plus diphenhydramine vs IV hydromorphone for migraine. Neurology. 2017 Nov 14;89(20):2075-2082. doi: 10.1212/WNL.0000000000004642. Epub 2017 Oct 18.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Headache Disorders, Primary
- Headache Disorders
- Migraine Disorders
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Autonomic Agents
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics
- Antiemetics
- Gastrointestinal Agents
- Dermatologic Agents
- Analgesics, Opioid
- Narcotics
- Antipsychotic Agents
- Tranquilizing Agents
- Psychotropic Drugs
- Dopamine Agents
- Dopamine Antagonists
- Hypnotics and Sedatives
- Anesthetics, Local
- Anti-Allergic Agents
- Sleep Aids, Pharmaceutical
- Histamine H1 Antagonists
- Histamine Antagonists
- Histamine Agents
- Antipruritics
- Diphenhydramine
- Promethazine
- Hydromorphone
- Prochlorperazine
Other Study ID Numbers
Other Study ID Numbers
- 2014-4325
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