Increasing the Severity of Headache Pain

Increasing the Severity of Headache Pain

The discomfort or pain felt in the head or upper neck region is referred to as headache pain. Headaches are one of the most common medical complaints, and their severity, duration, and specific symptoms can vary. They can range from mild to severe and chronic conditions that have a significant impact on a person’s daily life.

It is not uncommon for people who have suffered a concussion to experience moderate to severe headaches in the weeks following the injury. According to a new study, a combination of two drugs, both common anti-nausea medications, administered intravenously in the emergency room may relieve headaches better than a placebo. The study is published online issue of Neurology®, the medical journal of the American Academy of Neurology.

Metoclopramide is an anti-nausea medication that is occasionally used to treat migraines. Diphenhydramine is a common antihistamine that can be used to treat motion sickness when injected. Because higher intravenous doses of metoclopramide can cause restlessness, this study combined diphenhydramine with metoclopramide to prevent those symptoms.

The headaches you get after a trauma like a fall, an assault, or a car accident can linger for months or even years and lead to a reduced quality of life, so the results of our study are promising.

Benjamin W. Friedman

“The headaches you get after a trauma like a fall, an assault, or a car accident can linger for months or even years and lead to a reduced quality of life, so the results of our study are promising,” said study author Benjamin W. Friedman, M.D., of Albert Einstein College of Medicine in the Bronx, New York.

The study included 160 people who had a head trauma and then went to the ER for a headache within 10 days. They were divided into two groups at random: 81 people were given 20 mg of metoclopramide and 25 mg of diphenhydramine intravenously. The remaining 79 people were given a saline solution injection as a placebo.

One hour after the medication was administered, the researchers asked people to rate the intensity of their pain on a scale of zero to ten. On this scale, zero represents no pain and ten represents the worst pain imaginable.

Doubling down on headache pain

The drug combination reduced the average person’s pain level by more than five points one hour later, according to the study. People in the group given the combination of metoclopramide and diphenhydramine reported an average pain reduction of 5.2 points. On average, people in the placebo group reported that their pain had decreased by 3.8 points on a pain scale.

43% of those given the drug combination experienced side effects such as drowsiness, restlessness, or diarrhea. In the placebo group, 28% of people reported these types of side effects.

“More research is needed to determine the most effective dose of metoclopramide, and how long to administer it, to see if people can get longer-term relief after they leave the emergency room,” Friedman said. “Further research may also be able to determine whether early treatment with this medication can target other disruptive symptoms you may experience following a head injury, such as depression, sleep disorders, and anxiety.”

One limitation of the study is that the participants came from low-income areas of the country, where they may have had less access to care. Because successful headache treatment may be linked to access to care, these findings may not be generalizable to the general population.