The following is a summary of “Comparison of efficacy and frequency of akathisia and dystonia between olanzapine, metoclopramide and prochlorperazine in ED headache patients,” published in the March 2023 issue of Emergency Medicine by Chinn, et al.

For a study, researchers sought to assess the effectiveness and prevalence of akathisia and dystonia when treating headaches with the dopamine antagonist drugs olanzapine, metoclopramide, and prochlorperazine.

An extensive metropolitan level one trauma center’s patient population was the subject of the retrospective observational cohort study between 2010 and 2018. Age ≥18 with a headache as their primary complaint and treatment with either olanzapine, metoclopramide, or prochlorperazine met the inclusion criteria. The requirement for rescue medication was the main result. Receiving treatment for dystonia or akathisia was a secondary result. Logistic regression was employed to find differences between the three groups up to 72 hours after the initial presentation.

A total of 5,643 patients were eligible for inclusion. The most often used drug was olanzapine (n = 2,994, 53%), which was followed by prochlorperazine (n = 2,100, 37%) and metoclopramide (n = 549, 10%). There were no variations in risk for acquiring akathisia or dystonia once age and gender were considered.

They found no difference in risk of needing rescue medication or developing akathisia or dystonia during the initial ED visit and up to 72 hours after receiving olanzapine, metoclopramide, or prochlorperazine.

Reference: sciencedirect.com/science/article/pii/S0735675722007835