Study Shows Severe Migraines Can Be Treated Without IV

LOS ANGELES — Findings from a study from The Lundquist Institute could reduce a major source of headaches for severe migraine sufferers: hospital visits.

Many people suffering from migraine headaches can control them at home through common oral medications such as sumatriptan, but there’s a substantial population that requires professional treatment to mitigate the unbearable pain. For the last four decades, that treatment has consisted of the insertion of an intravenous line to pump medicine—most commonly prochlorperazine—directly into the patient’s bloodstream.

Dr. David Tanen of The Lundquist Institute was a lead investigator in a July study published in Acta Neurologica Scandinavica that sought to find a better way to treat severe migraines. The study showed that a dose of prochlorperazine absorbed buccally—through the mucus membranes inside the mouth—was just as effective in treating migraine pain as a comparable dose injected straight into the bloodstream. 

The study involved a randomized double-blind trial of 80 people between 18 and 65 years of age who sought treatment in hospital emergency rooms for their migraines. The subjects received either 6 mg of buccally absorbed prochlorperazine combined with a saline IV placebo, or 10 mg of intravenous prochlorperazine with a buccally absorbed sugar pill placebo.

There were similar effects on pain, nausea and sedation between the two groups, demonstrating that buccally absorbed prochlorperazine is an effective, non-invasive treatment for migraines, particularly compared to taking prochlorperazine intravenously.

“Our study shows that there is a way to treat severe migraines that doesn’t require painful needles or costly trips to the emergency room,” said Tanen. “An over-the-counter, buccally absorbed formulation of prochlorperazine could give severe migraine sufferers a dramatically better life.”

Currently, buccally absorbed prochlorperazine is not available either by prescription or over-the-counter in the United States, although it is in Europe. If buccally absorbed prochlorperazine were to be approved by the FDA for over-the-counter use in the United States, these patients could effectively treat their migraine headaches at home, eliminating the need to come to the emergency department. This would make their lives much easier and free up emergency resources for others.

“Migraine headaches are debilitating, and do not discriminate on who they affect,” said David Meyer, PhD, President and CEO of The Lundquist Institute. “Dr. Tanen’s work could meaningfully improve the lives of the millions suffering from severe headaches.”