{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T04:04:23Z","timestamp":1746417863261,"version":"3.40.4"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>The objectives are to determine whether diphenhydramine coadministered with prochlorperazine versus prochlorperazine only is associated with a difference in the risk of migraine treatment failure, as measured by the need for additional therapy, hospitalization rates, and 72-hour return rates, and to compare extrapyramidal adverse effects between groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Retrospective cohort of patients aged 7 to 18 years treated in the emergency department for migraines using prochlorperazine with or without diphenhydramine between 2013 and 2019. Patients were included if they had International Classification of Diseases, Ninth or Tenth Revision, codes for migraine or unspecified headache and were treated with prochlorperazine as part of their initial migraine therapy. Data collected included demographics, medications administered, pain scores, neuroimaging, disposition, return visits, and documentation of extrapyramidal adverse effects. Multivariable logistic regression was used to estimate the association between diphenhydramine coadministration and each of the outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 1683 patients were included. Overall, 13% required additional therapy with a 16.7% admission rate and a 72-hour return rate of 5.3%. There was no association between initial treatment with diphenhydramine and the odds of additional therapy (adjusted odds ratio [aOR], 0.74 [95% confidence interval {CI}, 0.53\u20131.03]), admission rates (aOR, 1.22 [95% CI, 0.89\u20131.67]), or return visit rates (aOR, 0.91 [95% CI, 0.55\u20131.51]). Extrapyramidal adverse effects occurred in 2.4% of patients in the prochlorperazine group and 0% in the prochlorperazine with diphenhydramine group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>There was no association between diphenhydramine coadministration and the need for additional therapy, 72-hour return visit rates or admission rates. Extrapyramidal effects did not occur in patients treated with diphenhydramine.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000003202","type":"journal-article","created":{"date-parts":[[2024,5,8]],"date-time":"2024-05-08T23:00:06Z","timestamp":1715209206000},"page":"e169-e173","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Diphenhydramine and Migraine Treatment Failure in Pediatric Patients Receiving Prochlorperazine"],"prefix":"10.1097","volume":"40","author":[{"given":"Sobia","family":"Naeem","sequence":"first","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Nicklaus Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan M.","family":"Lozano","sequence":"additional","affiliation":[{"name":"Department of Medical and Population Health Science Research, Florida International University Herbert Wertheim College of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria","family":"Ruiz Castaneda","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Nicklaus Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Lowe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1542\/peds.2014-2432","article-title":"A comparison of acute treatment regimens for migraine in the emergency department","volume":"135","year":"2015","journal-title":"Pediatrics"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/head.12042","article-title":"Effectiveness of standardized combination therapy for migraine treatment in the pediatric emergency department","volume":"53","year":"2013","journal-title":"Headache"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"2215","DOI":"10.1212\/01.WNL.0000147332.41993.90","article-title":"Practice parameter: pharmacological treatment of migraine headache in children and adolescents: report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society","volume":"63","year":"2004","journal-title":"Neurology"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1067\/mem.2001.113032","article-title":"Diphenhydramine for the prevention of akathisia induced by prochlorperazine: a randomized, controlled trial","volume":"37","year":"2001","journal-title":"Ann Emerg Med"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.ajem.2010.12.020","article-title":"Prochlorperazine in children with migraine: a look at its effectiveness and rate of akathisia","volume":"30","year":"2012","journal-title":"Am J Emerg Med"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.jemermed.2020.09.031","article-title":"Prophylactic administration of diphenhydramine to reduce neuroleptic side effects in the acute care setting: a systematic review and meta-analysis","volume":"60","year":"2021","journal-title":"J Emerg Med"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.jemermed.2008.08.012","article-title":"Clinical outcomes of children treated with intravenous prochlorperazine for migraine in a pediatric emergency department","volume":"39","year":"2010","journal-title":"J Emerg Med"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1001\/jama.2016.0649","article-title":"In-hospital outcomes and costs among patients hospitalized during a return visit to the emergency department","volume":"315","year":"2016","journal-title":"JAMA"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"750","DOI":"10.7326\/M14-1616","article-title":"Revisit rates and associated costs after an emergency department encounter: a multistate analysis","volume":"162","year":"2015","journal-title":"Ann Intern Med"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003202","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:10:40Z","timestamp":1746382240000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000003202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,9]]},"references-count":9,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000003202","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"type":"electronic","value":"1535-1815"},{"type":"print","value":"0749-5161"}],"subject":[],"published":{"date-parts":[[2024,5,9]]}}}