The use of intravenous magnesium sulphate for acute migraine: meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 23921817 · doi:10.1097/MEJ.0b013e3283646e1b
What was done
A systematic review and meta-analysis of double-blind, randomized controlled trials evaluating the efficacy and tolerability of intravenous magnesium sulphate for acute migraine in adults. Multiple databases (Cochrane, MEDLINE, EMBASE, CINAHL, ACP Journal Club, ClinicalTrials.gov, and conference proceedings) were searched, identifying 5 eligible randomized controlled trials covering 295 patients from 1,203 screened abstracts.
What was found
Headache relief at 30 minutes was 7% lower in the intravenous magnesium groups compared to controls, a non-significant difference (pooled risk difference = -0.07, 95% CI: -0.23 to 0.09). The need for rescue analgesic medication did not significantly differ between groups (pooled risk difference = -0.021, 95% CI: -0.16 to 0.12). Patients receiving magnesium experienced a statistically significant 37% higher rate of adverse events or side effects compared to controls (pooled risk difference = 0.370, 95% CI: 0.06 to 0.68).
Why it matters
This meta-analysis demonstrates that intravenous magnesium provides no therapeutic benefit over control treatments for acute migraine pain in the emergency setting while significantly increasing adverse side effects.
Limits
The total sample size across all included trials was small (5 studies, 295 patients). The abstract does not report specific doses, control substances used, long-term recurrence rates, or details on specific types of adverse events.
Cited by
- contradicts An intravenous magnesium push, especially combined with vitamin B6, can abate migraine headaches.