In this episode, I’ll discuss why dexamethasone is given for acute headache in the ED.
While not given as monotherapy, dexamethasone is often added to standard treatment of acute headache in patients presenting to the emergency department. This is done because dexamethasone has been shown to reduce migraine recurrence from 24 to 72 hours after treatment.
Multiple meta analyses support using dexamethasone for this indication, with one concluding a number needed to treat to reduce headache recurrence of 9 and another with an NNT of 10.
The doses studied ranged from 10 to 25 mg given either IV or IM.
In these studies of single doses of dexamethasone, adverse event rates did not differ between treatment and placebo groups.
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