Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults

Cochrane Database of Systematic Reviews, 2010

Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults - The Cochrane Library - Derry - Wiley Online Library from LOGIN Enter e-mail address Enter password REMEMBER ME > > > > DATABASE TOOLS DATABASE MENU FIND ARTICLES OTHER RESOURCES Intervention Review You have full text access to this content Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults Sheena Derry, R Andrew Moore, Henry J McQuay Editorial Group: Published Online: 10 NOV 2010 Assessed as up-to-date: 4 OCT 2010 DOI: 10.1002/14651858.CD008040.pub2 Copyright © 2010 The Cochrane Collaboration.
Publication History Publication Status: New Published Online: 10 NOV 2010 SEARCH ARTICLE TOOLS Abstract Abstract Background Migraine is a common, disabling condition and a burden for the individual, health services and society.
Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics.
Co-therapy with an antiemetic should help to reduce nausea and vomiting commonly associated with migraine.
Objectives To determine the efficacy and tolerability of paracetamol (acetaminophen), alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine in adults.
Selection criteria We included randomised, double-blind, placebo- or active-controlled studies using self-administered paracetamol to treat a migraine headache episode, with at least 10 participants per treatment arm.
Data collection and analysis Two review authors independently assessed trial quality and extracted data.
Numbers of participants achieving each outcome were used to calculate relative risk and numbers needed to treat (NNT) or harm (NNH) compared to placebo or other active treatment.
Main results Ten studies (2769 participants, 4062 attacks) compared paracetamol 1000 mg, alone or in combination with an antiemetic, with placebo or other active comparators, mainly sumatriptan 100 mg.
For all efficacy outcomes paracetamol was superior to placebo, with NNTs of 12, 5.2 and 5.0 for 2-hour pain-free and 1- and 2-hour headache relief, respectively, when medication was taken for moderate to severe pain.
Nausea, photophobia and phonophobia were reduced more with paracetamol than with placebo at 2 hours (NNTs of 7 to 11); more individuals were free of any functional disability at 2 hours with paracetamol (NNT 10); and fewer participants needed rescue medication over 6 hours (NNT 6).