{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T14:28:21Z","timestamp":1781015301590,"version":"3.54.1"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,1,16]],"date-time":"2014-01-16T00:00:00Z","timestamp":1389830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Headache"],"published-print":{"date-parts":[[2014,2]]},"abstract":"\n Background<\/jats:title>\n Tension\u2010type headache is highly prevalent in the general population and is a consistent if not frequent cause of visits to acute care settings. Analgesics such as nonsteroidal anti\u2010inflammatory drugs, acetaminophen, and salicylates are considered first\u2010line therapy for treatment of tension\u2010type headache. For patients who present to an acute care setting with persistent tension\u2010type headache despite analgesic therapy, it is not clear which parenteral agent should be administered. We performed a systematic review of the medical literature to determine whether parenteral therapies other than salicylates or nonsteroidals are efficacious for acute tension\u2010type headache.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We performed a systematic review of\n M<\/jats:styled-content>\n edline,\n EMBASE<\/jats:styled-content>\n ,\n CINAHL<\/jats:styled-content>\n ,\n G<\/jats:styled-content>\n oogle scholar, and the\n C<\/jats:styled-content>\n ochrane\n C<\/jats:styled-content>\n entral\n R<\/jats:styled-content>\n egistry of\n C<\/jats:styled-content>\n ontrolled\n T<\/jats:styled-content>\n rials from inception through\n A<\/jats:styled-content>\n ugust, 2012 using the search terms \u201ctension\u2010type headache\u201d and \u201cparenteral or subcutaneous or intramuscular or intravenous.\u201d Our goal was to identify randomized trials in which one parenteral treatment was compared to another active comparator or to placebo for the acute relief of tension\u2010type headache. Parenteral was defined as intravenous, intramuscular, or subcutaneous administration. We only included studies that distinguished tension\u2010type headache from other primary headache disorders, such as migraine. The primary outcome for this review was measures of efficacy one hour after medication administration. Data abstraction was performed by two authors. Disagreements were resolved by a third author. We assessed the internal validity of trials using the\n C<\/jats:styled-content>\n ochrane\n C<\/jats:styled-content>\n ollaboration risk of bias tool. Because of the small number of trials identified, and the substantial heterogeneity among study design and medications, we decided that combining data and reporting summary statistics would serve no useful function. The results of individual studies are presented using\n N<\/jats:styled-content>\n umber\n N<\/jats:styled-content>\n eeded to\n T<\/jats:styled-content>\n reat (\n NNT<\/jats:styled-content>\n ) with 95%\n CI<\/jats:styled-content>\n when dichotomous outcomes were available and continuous outcomes otherwise.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Our search returned 640 results. One hundred eighty\u2010seven abstracts were reviewed, and 8 studies involving 486 patients were included in our analysis. The most common reasons for exclusion of abstracts were no assessment of acute pain relief, use of nonparenteral medications only, and no differentiation of headache type. Risk of bias ranged from low to high. The following medications were more effective than placebo for acute pain (\n NNT<\/jats:styled-content>\n , 95%\n CI<\/jats:styled-content>\n ): metamizole (4, 2\u201026), chlorpromazine (4, 2\u201026), and metoclopramide (2, 1\u20103). The combination of metoclopramide\u2009+\u2009diphenhydramine was superior to ketorolac (4, 2\u20108) The following medications were not more effective than placebo: mepivacaine, meperidine\u2009+\u2009promethazine, and sumatriptan.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Various parenteral medications other than salicylates or nonsteroidals provide acute relief of tension\u2010type headache. Comparative efficacy studies are needed.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/head.12287","type":"journal-article","created":{"date-parts":[[2014,1,16]],"date-time":"2014-01-16T16:07:08Z","timestamp":1389888428000},"page":"260-268","source":"Crossref","is-referenced-by-count":24,"title":["Parenteral Treatment of Episodic Tension\u2010Type Headache: A Systematic Review"],"prefix":"10.1111","volume":"54","author":[{"given":"Danielle","family":"Weinman","sequence":"first","affiliation":[{"name":"Albert Einstein College of Medicine Bronx NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Nicastro","sequence":"additional","affiliation":[{"name":"Montefiore Medical Center Bronx NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olabiyi","family":"Akala","sequence":"additional","affiliation":[{"name":"NYU Langone Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin W.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine Bronx NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,1,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-2982.2000.00070.x"},{"issue":"1","key":"e_1_2_7_3_1","first-page":"1","article-title":"The International Classification of Headache Disorders \u2013 2nd edition","volume":"24","author":"Headache Classification Subcommittee of International Headache Society","year":"2004","journal-title":"Cephalalgia"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2008.01282.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-31802000000300002"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2006.11.004"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39412.705868.AD"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-006-0077-0"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2006.06.004"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2000.00143.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0b013e3283378d5c"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)01079-4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0004-282X2002000400004"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-879X2002001000005"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-2982.1992.00375.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2002.000356"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2013.03.017"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.2.507"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(90)92233-G"}],"container-title":["Headache: The Journal of Head and Face Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhead.12287","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.12287","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T09:59:39Z","timestamp":1762077579000},"score":1,"resource":{"primary":{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/10.1111\/head.12287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,1,16]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,2]]}},"alternative-id":["10.1111\/head.12287"],"URL":"https:\/\/doi.org\/10.1111\/head.12287","archive":["Portico"],"relation":{},"ISSN":["0017-8748","1526-4610"],"issn-type":[{"value":"0017-8748","type":"print"},{"value":"1526-4610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,1,16]]}}}