The Effect of Butyrophenones for the Management of Primary Headache in the Emergency Department: A Systematic Review and Meta-Analysis

Authors

  • Ahmed Alsuliamani Department of Emergency Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
  • Rizq badawi Department of Emergency Medicine, King Fahad Medical City, Riyadh, Saudi Arabia
  • Erich Hanel Assistant professor, Family medicine and Emergency medicine, McMaster University, ON, Canada
  • Sharafaldeen Bin Nafisah Disaster Management and Emergency Dispatch Center of King Fahd Medical City

DOI:

https://doi.org/10.52609/jmlph.v3i2.78

Abstract

BACKGROUND: The use of butyrophenones for headaches became plausible when the association was established between dopamine and headache. However, despite their positive effect on acute headaches, their use remains controversial.

AIM: The goal of this study is to ascertain whether the addition of haloperidol or droperidol to the treatment regimen for acute primary headache lowers the pain score of adult patients in the emergency department.

METHODS: A systematic review and meta-analysis was conducted. We searched the following databases for randomised controlled trials (RCTs): PubMed, Cochrane databases, and grey literature, from 1963 to October 2022. Included were RCTs conducted on the use of butyrophenones (IV haloperidol or IV/IM droperidol) in the acute management of primary headaches (diagnosed or undiagnosed), designated prospective, double-blind or open, using only the Visual Analogue Scale (VAS) with a specific measurement time. We excluded non-English studies that lacked translation, studies conducted on paediatric age groups, and studies conducted on animals.

RESULTS: Out of 49 articles we included seven, three of which investigated haloperidol. The mean difference in VAS score favoured haloperidol; -2.46 (95% CI: [-4.11 to -0.81]), indicating a drop in VAS score of 2.5/10 units. The mean difference in VAS score for the use of droperidol was -0.35 (95% CI: [-1.24 to 0.54]).

CONCLUSION: Haloperidol can induce an acute 25% reduction in VAS score when added to the regimen for acute headache management. It also reduces the need for rescue medications and improves patient satisfaction. Nonetheless, considerable side effects cannot be overlooked.

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Published

2023-06-14

How to Cite

Alsuliamani, A., Badawi, R., Hanel, E. ., & Bin Nafisah, S. (2023). The Effect of Butyrophenones for the Management of Primary Headache in the Emergency Department: A Systematic Review and Meta-Analysis. The Journal of Medicine, Law & Public Health, 3(2), 231–241. https://doi.org/10.52609/jmlph.v3i2.78

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Section

Reviews

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