Intravenous versus rectal prochlorperazine in the treatment of benign vascular or tension headache: a randomized, prospective, double-blind trial.

STUDY OBJECTIVE: To compare the effectiveness of i.v. and PR prochlorperazine for treatment of acute benign vascular or tension headache. DESIGN: Prospective, randomized, double-blind trial. SETTING: University emergency department with 50,000 annual census. PARTICIPANTS: Forty-five adult patients enrolled on 46 visits. INTERVENTIONS: Patients received 10 mg prochlorperazine i.v. and placebo suppository or 25 mg prochlorperazine PR and placebo injection. Pain assessment was made using a 10-cm visual-analog scale; scores were analyzed using Wilcoxon/Kruskal-Wallis rank-sum tests (alpha of .01). RESULTS: Mean 60-minute pain scores for i.v. and PR groups were 0.6 and 3.5, respectively (P = .0002). Two patients (8.7%) in the i.v. group and six patients (26.1%) in the PR group required rescue analgesia (P = .12). CONCLUSION: i.v. prochlorperazine appears to provide more effective relief than PR prochlorperazine for benign vascular or tension headaches.