100 Migraine Drugs A to Z: propofol

Propofol (Diprivan) was originally developed for general anesthesia during surgery. Smaller amounts were found to work well for “conscious sedation” to induce a semiconscious state for minor procedures such as colonoscopies.

In small doses, propofol appears to be effective for the treatment of migraines. A 2019 review of nine studies and case reports showed that “Propofol may be an effective rescue therapy for patients presenting to the ED for acute migraine, but its place in therapy based on the limited available evidence is unknown.”

Propofol was also tested for the emergency room treatment of 66 children with migraines. It was found to be as effective as the standard therapy but those give propofol had a lower rate of headache recurrence within 24 hours.

Propofol is a drug of abuse that was in part responsible for the death of Michael Jackson (it was one of several drugs found in his body). Because it is given only intravenously and is not easy to get, most of the cases of addiction reported occurred in healthcare professionals.

Propofol is administered only intravenously and at anesthetic doses it can have serious side effects such as a drop in blood pressure. However, it appears very safe for conscious sedation and is probably even safer at small doses used for migraines.

It should be considered when a patient does not respond to other intravenous therapies such as ketorolac, metoclopramide, and dihydroergotamine.