While steroids don’t relieve the pain of a migraine, it appears that they may help keep migraine from recurring, according to a systematic review of seven studies that compared the ability of a single injection of the corticosteroid dexamethasone to relieve pain or stop headache recurrence. The steroid provided similar acute pain reduction as a placebo. However, it was more effective than placebo in reducing recurrence rates.
“Dexamethasone is readily available and familiar to doctors in most parts of the world,” the study review team wrote in BMJ (the British Medical Journal), “and when used as a single parenteral [injectable] dose—as in all of the included trials—it is well tolerated, causing only minor side effects.”
An injection of the steroid, in combination with an abortive drug (such as a triptan), was associated with a 26% reduction in headache recurrence within 72 hours. The study authors noted that healthcare providers often consider headache recurrence to be less important than headache sufferers do, “suggesting that treatments to reduce headache recurrence should be a high priority in migraine research.”
Use of steroid injection may help the nearly half of migraine sufferers whose headaches recur within 24 hours of visiting an emergency room. However, patients with frequent migraines could be at greater risk for side effects from repeated use of corticosteroids.