Headache treatment after electroconvulsive treatment: a single-blinded trial comparator between eletriptan and paracetamol

Abstract

Background: After electroconvulsive treatment (ECT), headaches are a very frequent but underreported adverse effect. We conducted a study comparing the efficacy and tolerability of eletriptan versus paracetamol for this indication.

Methods: Twenty consecutive ECT-treated patients who reported headaches thereafter were recruited; they underwent a headache questionnaire and a Visual Analog Scale (VAS) evaluation on headache intensity at baseline. The VAS was readministered at 30 minutes, 2 hours, and 4 hours after drug intake. Drug allocation was randomly assigned by the ECT nurse, the patient and the investigator being blinded to which drug was given after each ECT session.

Results: Of 72 patients screened, 20 (28%) complained of headaches and 19 (95%) completed the study drug protocol. Eleven patients (55%) had diffuse headaches, and 9 (45%) had localized headaches (2 occipital, 4 frontal, and 3 temporal). Eight patients (40%) had pressure type, 7 aching, and 5 had dull headaches. In 14 patients (70%), sleep improved headaches. The mean (SD) headache intensity (on VAS) was 54.2 (17.4) in the eletriptan group and 51.6 (19.3) in the paracetamol group at baseline, 17.9 (16.7) and 35 (17.24), respectively, at 30 minutes (P < 0.0001), and 1.7 (2.9) and 21.1 (14.88), respectively, at 2 hours (P < 0.0001). At 4 hours, none of the patients in the eletriptan group had any headaches, whereas in the paracetamol group, the VAS was 4.8 (5.1) (P = 0.120). The mean (SD) headache duration was 1.61 (1.09) hours in the eletriptan versus 3.55 (1.19) hours in the paracetamol group (P < 0.0001).

Conclusions: Our study showed that both eletriptan and paracetamol relieve post-ECT headaches, but eletriptan showed superiority in reducing the intensity and duration of the headaches in this small treatment group.