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July 28, 1989

Intravenous Prochlorperazine for Acute Headache

Author Affiliations

Diamond Headache Clinic Chicago, Ill

Diamond Headache Clinic Chicago, Ill

JAMA. 1989;262(4):501-502. doi:10.1001/jama.1989.03430040071025

To the Editor. —  Use of intravenous prochlorperazine edisylate for the treatment of headache, as recommended by Jones et al,1 must be reviewed with caution because this therapy does not offer a simple panacea for emergency department treatment of headache.In the article, the diagnostic criteria used in establishing the diagnosis are not specified clearly. The occurrence of associated gastrointestinal tract and neurological symptoms are necessary for establishing the diagnosis of migraine.2 Only 12 of 82 patients who participated experienced these symptoms, although 41 were diagnosed with migraine headache. An additional 23 patients were diagnosed with both migraine and tension headaches. These data are questionable in light of the authors' description of the "chaotic nature of emergency practice." It should be noted that the classification "vascular headaches"2 encompasses headaches caused by both infection and hypertension, which are found in 39.3% and 4.8%, respectively, of patients in the