Intravenous Prochlorperazine for Acute Headache-Reply

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Abstract
In Reply.— We thank Drs Diamond, Freitag, and Feldman for their comments regarding our article. We share their concerns about the overzealous use of prochlorperazine (eg, prescribed at higher doses or as long-term prophylaxis) without further investigation. The incidence of extrapyramidal symptoms in patients who take prochlorperazine has been reported as 0.5% (5/1001).1 No reactions occurred in patients receiving less than 10 mg of prochlorperazine.1As described in our article, extrapyramidal symptoms can be minimized further by avoiding the use of prochlorperazine in susceptible individuals (eg, children). The most feared complication of antipsychotic drug therapy is tardive dyskinesia. However, this disorder is more common in the elderly and more likely to occur with exposure to high doses and during prolonged treatment.2,3Our collective experience during the past 8 years has shown intravenous prochlorperazine to be extremely safe as well as efficacious for the short-term treatment of acute headache

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