Evidence map›Paper›PMID 37291500›Full record

SynthesisBMC neurology2023

The efficacy and safety of metoclopramide in relieving acute migraine attacks compared with other anti-migraine drugs: a systematic review and network meta-analysis of randomized controlled trials.

Hanaa Abdelmonem, Hebatallah Mohamed Abdelhay, Gehad Taha Abdelwadoud, Amira Naser Mohammed Alhosini, Ahmed Eissa Ahmed, Samaher Walied Mohamed, Nada Mostafa Al-Dardery, Mohamed Abd-ElGawad, Mohamed Abdelmonem Kamel

Open access · goldAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in BMC neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 3 syntheses or guidelines pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. The epidemiology and phenomenology of non-antipsychotic-induced dystonia: a hybrid systematic-narrative review.European psychiatry : the journal of the Association of European Psychiatrists · 2025
    Pooled it
  4. Trial
  5. Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Hanaa AbdelmonemMBBCh, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Hebatallah Mohamed AbdelhayClinical Oncology Resident at Fayoum University Hospital, Fayoum, Egypt.
Gehad Taha AbdelwadoudFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Amira Naser Mohammed AlhosiniClinical Oncology Resident at Fayoum University Hospital, Fayoum, Egypt.
Ahmed Eissa AhmedMBBCh, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Samaher Walied MohamedFamily Medicine Resident at Fayoum University Hospital, Fayoum, Egypt.
Nada Mostafa Al-DarderyFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Mohamed Abd-ElGawadMBBCh, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Mohamed Abdelmonem KamelMBBCh, Faculty of Medicine, Fayoum University, Fayoum, Egypt. ma3701@fayoum.edu.eg.ORCID https://orcid.org/0000-0001-8472-269X
Fayoum University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany drugs are prescribed in relieving acute migraine attacks, we aim to compare metoclopramide with other antimigraine drugs.

methodsWe searched online databases like PubMed, Cochrane Library, Scopus, and Web of Science till June 2022 for RCTs that compared metoclopramide alone with placebo or active drugs. The main outcomes were the mean change in headache score and complete headache relief. The secondary outcomes were the rescue medications need, side effects, nausea and recurrence rate. We qualitatively reviewed the outcomes. Then, we performed the network meta-analyses (NMAs) when it was possible. which were done by the Frequentist method using the MetaInsight online software.

resultsSixteen studies were included with a total of 1934 patients: 826 received metoclopramide, 302 received placebo, and 806 received other active drugs. Metoclopramide was effective in reducing headache outcomes even for 24 h. The intravenous route was the most chosen route in the included studies and showed significant positive results regarding headache outcomes; however, the best route whether intramuscular, intravenous, or suppository was not compared in the previous studies. Also, both 10 and 20 mg doses of metoclopramide were effective in improving headache outcomes; however, there was no direct comparison between both doses and the 10 mg dose was the most frequently used dosage. In NMA of headache change after 30 min or 1 h, metoclopramide effect came after granisetron, ketorolac, chlorpromazine, and Dexketoprofen trometamol. Only granisetron's effect was significantly higher than metoclopramide's effect which was only significantly higher than placebo and sumatriptan. In headache-free symptoms, only prochlorperazine was non-significantly higher than metoclopramide which was higher than other medications and showed significantly higher effects only with placebo. In rescue medication, metoclopramide's effect was only non-significantly lower than prochlorperazine and chlorpromazine while its effect was higher than other drugs and showed higher significant effects only than placebo and valproate. In the recurrence rate, studies showed no significant difference between metoclopramide and other drugs. Metoclopramide significantly decreased nausea more than the placebo. Regarding side effects, metoclopramide showed a lower incidence of mild side effects than pethidine and chlorpromazine and showed a higher incidence of mild side effects than placebo, dexamethasone, and ketorolac. The reported extrapyramidal symptoms with metoclopramide were dystonia or akathisia.

conclusionA dose of 10 mg IV Metoclopramide was effective in relieving migraine attacks with minimal side effects. Compared to other active drugs, it only showed a lower significant effect compared with granisetron regarding headache change while it showed significantly higher effects only with placebo in both rescue medication needs and headache-free symptoms and valproate in only rescue medication need. Also, it significantly decreased headache scores more than placebo and sumatriptan. However, more studies are needed to support our results.

Indexed as

MetoclopramideMigraine DisordersChlorpromazineGranisetronHeadacheHumansKetorolacNauseaProchlorperazineRandomized Controlled Trials as TopicSumatriptanValproic AcidChlorpromazineGranisetronKetorolacMetoclopramideProchlorperazineSumatriptanValproic AcidMetoclopramideMigraineNauseaVomiting

Identifiers

PMID37291500
PMCPMC10249175
OpenAlexW4379966822

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.