Objective:We prospectively evaluated the safely and efficacy of open-label droperidol, administered intramuscularly (IM), for treatment of acute migraine headache of severe intensity, and refractory to more conventional abortive agents. Patients: Twenty-three consecutive patients with acute migraine headache who presented at an emergency department or a specialized headache center, and who did not respond to treatment with various abortive agents. Material and Methods: Droperidol was administered IM at an initial dose of 2.5mg. The interval between treatment and subjective perception of headache relief was recorded. If no relief was achieved by 30 to 60 minutes after treatment, and no significant side effects were reported, a second dose of droperidol 2.5mg was administered. Rescue therapy of meperidine 75mg IM and promethazine 25mg IM, were administered to those not responding to droperidol. Results: Eighteen patients (78 percent) received one dose of droperidol 2.5mg, and five patients (22 percent) required droperidol 5mg. A clinically significant reduction in headache intensity within 1 hour postdose was experienced by 17 patients (74 percent). Five patients had no relief and one patient complained of worsening headache. Complete resolution of the headache was reported by 11 patients (48 percent) and 125 patients (65 percent) stated they were willing to take similar medication in the future. Varying degrees of akathisia following treatment were reported by six patients (26 percent). Conclusion: These results suggest that a low dose of IM droperidol may represent a safe, convenient, and effective treatment for acute severe migraine.
