Increasing the Severity of Headache Pain

A headache usually causes pain in the head, face, or neck. If you are experiencing severe, unusual pain or other signs and symptoms, seek immediate medical attention. Your headache could be a symptom of a more serious illness or health condition. Headaches can be uncomfortable, painful, and even incapacitating, but they are usually not causing concern. The majority of headaches are not caused by serious problems or medical conditions.

It is not uncommon for people who have suffered a concussion to experience moderate to severe headaches in the weeks following the injury. According to a new study, a combination of two drugs, both common anti-nausea medications, administered intravenously in the emergency room may relieve headaches better than a placebo. The study is published in the online issue of Neurology®, the medical journal of the American Academy of Neurology.

Most people don’t realize how complicated headaches can be. Different types can have their own set of symptoms, occur for different reasons, and require different treatments. Once you know what kind of headache you have, you and your doctor can find the best treatment for it and even try to prevent it.

The headaches you get after a trauma like a fall, an assault, or a car accident can linger for months or even years and lead to a reduced quality of life. More research is needed to determine the most effective dose of metoclopramide and how long to administer it to see if people can get longer-term relief after they leave the emergency room.

Benjamin W. Friedman

Metoclopramide is an anti-nausea medication that is occasionally used to treat migraines. Diphenhydramine is a common antihistamine that, when injected, can be used to treat motion sickness. Because higher intravenous doses of metoclopramide can cause restlessness, this study combined diphenhydramine with metoclopramide to alleviate those symptoms.

“The headaches you get after a trauma like a fall, an assault, or a car accident can linger for months or even years and lead to a reduced quality of life,” said study author Benjamin W. Friedman, M.D., of Albert Einstein College of Medicine in the Bronx, New York.

The study included 160 people who had head trauma and then went to the ER for a headache within 10 days. They were divided into two groups at random: Intravenously, 81 people were given 20 milligrams (mg) of metoclopramide and 25 milligrams (mg) of diphenhydramine. The remaining 79 people were given a saline solution injection as a placebo.

Doubling down on headache pain

One hour after the medication was administered, the researchers asked people to rate the intensity of their pain on a scale of zero to ten. On this scale, zero represents no pain and ten represents the worst pain imaginable.

The drug combination reduced the average person’s pain level by more than five points one hour later, according to the study. People in the group given the combination of metoclopramide and diphenhydramine reported an average pain reduction of 5.2 points. On average, people in the placebo group reported that their pain had decreased by 3.8 points on a pain scale.

Side effects such as drowsiness, restlessness, or diarrhea were reported by 43% of those given the drug combination. In the placebo group, 28% of people reported these types of side effects.

“More research is needed to determine the most effective dose of metoclopramide and how long to administer it for to see if people can get longer-term relief after they leave the emergency room,” Friedman said. “Further research may be able to determine whether early treatment with this medication can target other disruptive symptoms you may experience after a head injury, such as depression, sleep disorders, and anxiety.”

Dehydration, muscle tension, nerve pain, fever, caffeine withdrawal, drinking alcohol, or eating certain foods are common causes of normal headaches. They can also occur as a result of a toothache, hormonal changes, or pregnancy, or as a medication side effect. Migraine pain can strike without warning and be severe and incapacitating. If you suffer from chronic migraines, consult your doctor about treatment options to help you manage the pain.

One limitation of the study is that the participants came from low-income areas of the country, where they may have had less access to care. Because successful headache treatment may be linked to access to care, these findings may not be generalizable to the general population.