A recent prospective quasi-experimental study published in the Korean Journal of Pain suggested that both intravenous caffeine and magnesium sulfate are effective in reducing the severity of migraine pain.

Migraine is characterised by throbbing, unilateral pain in the head along with vomiting, nausea, phonophobia, and photophobia. The evidence demonstrates that intravenous magnesium sulfate might be useful in reducing pain in migraine. Intravenous caffeine was also effective in decreasing the severity of migraine headache, as suggested by results of a pilot study.

Baratloo, et al conducted a study which aimed to investigate the efficacy of magnesium sulfate vs intravenous caffeine citrate for management of acute headache. The study conducted a quasi-experimental survey in two academic medical centres of Shahid Beheshti University of Medical Sciences (Tehran), Iran from January until May 2016. The patients admitted to the emergency department and those who met the migraine diagnosis criteria as defined by the International Headache Society were included. Patients were assigned to 2 groups: One group was administered with 2 g intravenous magnesium sulfate and the second group was administered with 60 mg intravenous caffeine. Pain scores were determined using the visual analogue scale (VAS) at baseline and one to two hours after administering the drug. To analyse the baseline characteristics Chi-Square test and student t-test were used. Wilcoxon signed-rank test and Mann-Whitney U test were used to evaluate differences in the visual analogue scale (VAS) score between and within the section consequently. A total of 70 patients (35 patients in each section) with the mean age of 33.1 ± 11.3 years were involved, 64.3% women.

The results indicated a significant reduction in median pain scores after 1 and 2 hours of administration in both the Magnesium and Caffeine citrate group. However, the reduction in VAS pain score was more significant in the magnesium sulfate group than the Caffeine citrate group after one and two hours of administration. The study findings suggested that both intravenous caffeine and magnesium sulfate exhibits the potential to reduce headache severity, however, magnesium sulfate is more effective for short-term treatment of migraine headache in ED patients.