Arquivos de neuro-psiquiatria
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Randomized Controlled Trial Comparative Study
[Comparison of intravenous dipyrone to intravenous metoclopramide in the treatment of acute crisis of migraine: randomized clinical trial].
Migraine is one of the commonest diseases of clinical practice. ⋯ There was no difference about the intensity of pain reduction neither about the development of collateral effects comparing dipyrone to metoclopramide.
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Randomized Controlled Trial Clinical Trial
Intravenous chlorpromazine in the acute treatment of episodic tension-type headache: a randomized, placebo controlled, double-blind study.
Acute headache is a very frequent symptom, responsible for a significant percentage of caseload at primary care units and emergency rooms. Chlorpromazine is easily available in such settings. The aim of this study is to conduct a randomized, placebo-controlled, double-blind study to assess the efficacy of chlorpromazine on the acute treatment of episodic tension-type headache. ⋯ The number needed to treat (NNT, the reciprocal or the therapeutic gain) was 2.7 in 30 minutes and 1.8 in 60 minutes. There were reductions in the recurrence and in the use of rescue medication in the chlorpromazine group. We can conclude that intravenous chlorpromazine is an effective drug to relief the pain in tension-type headache.
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Randomized Controlled Trial Clinical Trial
[Intramuscular diclofenac in the acute treatment of migraine: a double-blind placebo controlled study].
The aim of this study is to assess, in a double blind fashion, the effect of diclofenac on the pain and associated symptoms in patients with acute migraine. 60 patients with migraine with aura and 60 patients with migraine without aura were assigned at random to receiving intramuscular diclofenac, 75 mg associated to intravenous physiological saline, 10 ml, or physiological saline alone. We used 3 parameters of analgesic evaluation and an analogical scale to asses associated symptoms. We also observed the recurrence and rescue medication percentiles. ⋯ They did not present difference, compared to placebo, on the intensity of associated symptoms. We observed a reduction on the recurrence and rescue medication utilization. Despite being an option to treat migraines attacks in the emergency room settings, diclofenac has a slow onset action and no effects on the associated symptoms.
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Randomized Controlled Trial Clinical Trial
[Efficacy of three drugs in the treatment of migrainous aura: a randomized placebo-controlled study].
In spite of the enormous amount of research regarding classification, epidemiology, diagnosis, pathophysiology and treatment of migraines, aura, one of its hallmarks, stays much less studied. The objective of this study is, therefore, to evaluate the evolution of aura in patients submitted to placebo and three different drugs available in Brazilian public health units. We studied 86 patients during an acute migrainous attack, with aura at the moment of the evaluation. ⋯ Magnesium sulphate was superior to placebo (p <0,05) 30 and 60 minutes after its administration. Dipyrone and chlorpromazine reduced the duration of the aura, when compared to placebo, 60 minutes following their administration. Our findings make possible some speculations about the pathophysiology of migraine, as well as about the therapeutic approach of patients presenting migrainous aura.
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Randomized Controlled Trial Clinical Trial
[Evaluation of placebo use in migraine without aura, migraine with aura and episodic tension-type headache acute attacks].
This study presents an evaluation of placebo response in the acute treatment of migraine with or without aura and episodic tension type headache. We studied patients admitted between March 1st,1997 and November 31st,1999 in two Emergency Room Units. Three groups had been defined, each one with 30 participants: migraine without aura (MWOA), migraine with aura (MWA) and episodic tension-type headache (ETTH). ⋯ After one hour of placebo administration, 50% of MWOA patients, 23.3% of MWA and 26.7% of ETTH had presented pain relief. The mean of this relief, evaluated by the numerical pain scale, was 41.6%, 23.1% and 36%, respectively. Use of placebo is essential in evaluating the therapeutic role of drugs used in the treatment of acute headache.