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A recent controlled study reported no benefit from intravenous steroids in the emergency department treatment of migraine headaches (Journal Watch Emergency Medicine Jan 25 2008). Now, a randomized, double-blind, placebo-controlled Australian study finds that adding oral dexamethasone to phenothiazine treatment of migraine does not reduce the likelihood of headache recurrence.
A convenience sample of 63 adult patients who presented to one of three EDs with physician-diagnosed migraine first received IV phenothiazines (12.5 mg prochlorperazine or 12.5–50 mg chlorpromazine administered with 1–2 L normal saline solution) and then were randomized to receive either a single dose of oral dexamethasone (8 mg) or placebo. Telephone follow-up of 61 p…