CJEM Articles: magnesium

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  • Intravenous magnesium for acute benign headache in the emergency department: a randomized double-blind placebo-controlled trial
    September 2004 6 5
    Carin M. Olson, Klaus B. Shuler, Leonard R. Frank, Salma F. Gharib

    Background: Magnesium deficiency may play a role in the pathogenesis of migraines and other headaches. Studies in outpatient clinics have found that magnesium administered intravenously (IV) reduces headache pain. We investigated the effectiveness of IV magnesium in patients with acute benign headache who presented to the emergency department (ED).

    Methods: This randomized double-blind placebo-controlled trial compared 2 g of IV magnesium versus placebo for the treatment of patients with acute benign headache who presented to the EDs of two teaching hospitals. Pre- and post-treatment pain scores were measured on a 100-mm visual analog pain scale.

    Results: Forty-two patients were randomized, 21 in each treatment group. Treatment groups had similar baseline characteristics. After treatment, placebo recipients reported an 8-mm median improvement in pain, and magnesium recipients had a 3-mm improvement (p = 0.63). We found no statistically significant difference between groups for any secondary outcomes; however, the patients who received magnesium had significantly (p = 0.03) more side effects than did those in the placebo group.

    Conclusions: We found no benefit to using IV magnesium to treat patients with acute benign headache who present to the ED.

  • When the MAGIC stops: magnesium in acute coronary syndromes -- a lesson in medical humility
    March 2004 6 2
    Mel Herbert, Shannon Patrick

    There has been much debate as to whether magnesium, a well-tolerated, readily available and cheap therapy, should be used to treat patients with suspected myocardial infarction. Despite promising results from animal studies and small clinical trials conducted in the 1980s, two large recent trials have concluded that the once phenomenal treatment is ineffective. The story of magnesium for acute myocardial infarction is a lesson in medical humility.