Current Approach to Undifferentiated Headache Management in the Emergency Department

Curr Pain Headache Rep. 2019 Mar 14;23(4):26. doi: 10.1007/s11916-019-0765-1.


Purpose of review: To discuss pharmacological interventions in the emergency department (ED) setting for the management of acute primary headache.

Recent findings: Acute headache treatment in the ED has seen an expansion in terms of possible pharmacological interventions in recent years. After a thorough evaluation ruling out dangerous causes of headache, providers should take the patient's history, comorbidities, and prior therapy into consideration. Antidopaminergics have an established role in the management of acute, severe, headache with manageable side-effect profiles. However, recent studies suggest anesthetic and anti-epileptic drugs may play roles in headache treatment in the ED. Current literature also suggest steroids as a promising tool for emergency department clinicians combating the readmission of patients with recurrent headaches. Emergency medicine providers must be cognizant of these traditional and emerging therapies in order to optimize the care of headache patients.

Keywords: Acute; Emergency department; Headache; Primary; Treatment.

Publication types

  • Review

MeSH terms

  • Analgesics / therapeutic use
  • Emergency Service, Hospital*
  • Headache / drug therapy*
  • Humans
  • Pain Management / methods*


  • Analgesics