R.E.B.E.L.EM - July 13, 2020 - By Mark Ramzy
Paper: Treatment of Headache in the Emergency Department: Haloperidol in the Acute Setting (THE-HA Study): A Randomized Clinical Trial. J Emerg Med 2020. PMID: 32402480
"Clinical Question: What is the effectiveness of 2.5mg of IV haloperidol compared to placebo in the treatment of acute headache in ED patients aged 13 to 55 years old?
Author’s Conclusions:
- This study suggests that 2.5 mg IV haloperidol is a rapid and effective treatment for acute, severe, benign headache in ED patients aged 18 to 55 years. Further study is warranted to confirm these results in adolescents
Our Conclusion:
- Although a small sample size, the use of low dose IV haloperidol appears to be effective in the acute treatment of benign headaches in the adult emergency department patient. The low adverse effects observed in this study, specifically QT prolongation, suggest that the use of haloperidol may be a safe first line agent in the treatment of benign headache. Given the small sample size of pediatric patients in this study, these findings cannot be applied to patients under the age of 18 years old until additional research has been performed.
Clinical Bottom Line:
- With a low side-effect profile, emergency physicians should consider the use of 2.5 mg IV haloperidol as a rapid and effective treatment for acute benign headache in adult emergency department patients aged 18 to 55 years old."