Trial reportThe American journal of emergency medicine2018
An exploratory study of IV metoclopramide+diphenhydramine for acute post-traumatic headache.
Trial report in The American journal of emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04799015 (A Randomized Study of Dexamethasone as Adjuvant Therapy for Acute Post-traumatic Headache), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Study of Dexamethasone as Adjuvant Therapy for Acute Post-traumatic Headache
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Acute and preventive pharmacological treatment of post-traumatic headache: a systematic review.The journal of headache and pain · 2019Pooled it
- Randomized Study of Metoclopramide Plus Diphenhydramine for Acute Posttraumatic Headache.Neurology · 2021Trial
- Phenotype-guided Management of Post-traumatic Headache: An Update on Pathophysiology and Treatment.Current pain and headache reports · 2026Review
- Efficacy of outpatient infusion therapy in pediatric patients with postconcussive headaches.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2022Article
- Models for Treating Post-traumatic Headache.Current pain and headache reports · 2021Review
- Post-Traumatic Headache in Children and Adolescents: a Narrative Review with a Focus on Management.Current neurology and neuroscience reports · 2020Review
- The Relation between Persistent Post-Traumatic Headache and PTSD: Similarities and Possible Differences.International journal of environmental research and public health · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundHeadache is a frequent complaint among the 1.4 million patients who present to US emergency departments (ED) annually following trauma to the head. There are no evidence-based treatments of acute post-traumatic headache.
methodsThis was an ED-based, prospective study of intravenous (IV) metoclopramide 20mg+diphenhydramine 25mg for acute post-traumatic headache. Patients who presented to our EDs with a moderate or severe headache meeting international criteria were enrolled and followed by telephone 2 and 7days later. The primary outcome was "sustained headache relief" (headache level less than "moderate" in the ED, no additional headache medication, and no relapse to headache worse than "mild").We also gathered data on associated symptomotology using the validated Post Concussion Symptom Scale (PCSS).
results21 patients were enrolled. Twelve of 20 (60%) patients with available follow-up data reported sustained headache relief. All but one of the 21 enrolled patients (95%) reported improvement of headache to no worse than mild. Seven of 19 (37%) patients with available data reported moderate or severe headache during the 48h after ED discharge. One week later, 5/19 patients reported experiencing headaches "frequently" or "always". The mean Post Concussion Symptom Score improved from 47.5 (SD 29.4) before treatment to 10.9 (SD 14.8) at the time of ED discharge and 11.4 (SD 21.4) at one week after treatment.
conclusionIV metoclopramide 20mg+diphenhydramine 25mg is an effective and well-tolerated medication regimen for patients presenting to the ED with acute post-traumatic headache, though 1/3 of patients report headache relapse after ED discharge and 1/4 of patients report persistent headaches one week later.
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