Chlorpromazine in treatment of acute migraine attacks in children & adolescents
Date First Published:
July 7, 2010
Last Updated:
July 15, 2010
Report by:
Leah Gorodi, Medical Student (University of Manchester)
Three-Part Question:
In [children and adolescents with known migraine] is [chlorpromazine effective] at [resolving symptoms]?
Clinical Scenario:
A 12 year old girl presents to the Emergency Department with a one hour history of a severe throbbing headache and an episode of nausea and vomiting 20 minutes previously. She is a known migraine sufferer, and her last episode was one week ago. After history and clinical examination, a diagnosis of migraine is made. You wonder whether Chlorpromazine would be effective in relieving her symptoms.
Search Strategy:
Medline 1950-July 2010 using Ovid interface
EMBASE 1980-July 2010 using Ovid interface
Cochrane Database of Systematic Reviews (July 2010)
EMBASE 1980-July 2010 using Ovid interface
Cochrane Database of Systematic Reviews (July 2010)
Search Details:
Medline
[(Exp migraine disorders OR exp Headache OR exp Primary Headache Disorders OR exp Headache Disorders) AND (exp Chlorpromazine) AND (LIMIT to English language AND Humans) AND (LMIT to “All Child (0-18 years)”)]
EMBASE
[(Exp migraine aura OR exp migraine without aura OR exp migraine with aura OR exp migraine OR exp headache OR exp primary headache) AND (exp chlorpromazine) AND (LIMIT to (Human and English Language)) AND (LIMIT to (child <unspecified age> OR preschool child <1 to 6 years> OR school child <7 to 12 years> OR adolescent <13 to 17 years>)
Cochrane Database of Systematic Reviews (July 2010)
Search’migraine’ (ti,ab,kw)
[(Exp migraine disorders OR exp Headache OR exp Primary Headache Disorders OR exp Headache Disorders) AND (exp Chlorpromazine) AND (LIMIT to English language AND Humans) AND (LMIT to “All Child (0-18 years)”)]
EMBASE
[(Exp migraine aura OR exp migraine without aura OR exp migraine with aura OR exp migraine OR exp headache OR exp primary headache) AND (exp chlorpromazine) AND (LIMIT to (Human and English Language)) AND (LIMIT to (child <unspecified age> OR preschool child <1 to 6 years> OR school child <7 to 12 years> OR adolescent <13 to 17 years>)
Cochrane Database of Systematic Reviews (July 2010)
Search’migraine’ (ti,ab,kw)
Outcome:
4 papers found in Medline, none were relevan
45 papers found in EMBASE, none were relevant
98 papers found in Cochrane, 1 was relevant
45 papers found in EMBASE, none were relevant
98 papers found in Cochrane, 1 was relevant
Relevant Paper(s):
| Study Title | Patient Group | Study type (level of evidence) | Outcomes | Key results | Study Weaknesses |
|---|---|---|---|---|---|
| Drugs for treating acute migraine headaches in children and adolescents (protocol) L. Billinghurst, L. Richer, KF Russell et al 2009; awaiting review Canada | currently under construction | Intervention Protocol for a review | Objective;To describe and assess the evidence from controlled trials on the efficacy and tolerability of pharmacological interventions by any route of administration versus placebo or other drug treatments for acute attacks of migraine in children | Results are currently unavailable, but eventually may be relevant to clinical question. |
Author Commentary:
Chlorpromazine belongs to the class of phenothiazines. It is has been used as a typical antipsychotic, but may have beneficial properties for the treatment of migraines as well as possibly having an antiemetic effect. There are currently no quality trials or studies for the use of Chlorpromazine for migraine attacks in children or adolescents. It is evident that there is a clinical need for more research into its use and effects for this population.
Bottom Line:
No conclusions can be made as to whether Chlorpromazine is effective in treatment of migraine in children and adolescents.
References:
- L. Billinghurst, L. Richer, KF Russell et al . Drugs for treating acute migraine headaches in children and adolescents (protocol)