Migraines

Acute Treatment

• IV Compazine + Benadryl + IV Decadron 10 mg
• IV Reglan + Benadryl + IV Decadron 10 mg
• Magnesium Sulfate (1 gram in 100 mL saline)
• Ketamine (0.2 mg/kg) IV
  
• SQ or PO Triptan

Discharge Treatment (up to 75% of patients experience recurrence of headache after discharge)

• Naproxen 500 mg PO
• Triptan
• Triptan + Naproxen
• Triptan + Naproxen + anti-emetic
  

Triptan Contraindications

• Uncontrolled HTN
• Uncontrolled DM
• PMH of CAD or CVA or HL
• FHx of CAD or MI

ALTERNATIVE

• Paraspinous cervical injection
• Video