Ketorolac in the Treatment of Acute Migraine: A Systematic Review

Neurology PGY1 PGY2 PGY3 PGY4

There are different approaches to Migraine HA, Narcotics, Triptans, NSAIDS, Steroids, … but my approach is combination of Metoclopramide and Diphenhydramine.

Headache The Journal of Head and Face Pain” Published a Systematic Review regarding Toradol and Migraine headache in Jan, and the conclusion is:
“Ketorolac should not be the first agent for treating migraine but is more effective than sumatriptan; butĀ  it may not be as effective as metoclopramide/phenothiazine agents.”

If you are interested to read more, “Headache” in March 2012 had another study regarding Migraine “Rescue therapy for acute migraine, part 3: opioids, NSAIDs, steroids, and post-discharge medications.
One of their conclusions was “Metoclopramide was equivalent to prochlorperazine, and, when combined with diphenhydramine, was superior in efficacy to triptans and NSAIDs.” we had a study in Annals of Emergency MedicineĀ  for combination of Metoclopramide and Diphenhydramine.

Link to Headache