IV Therapy for Migraine: What the Research Shows
A physician's look at IV therapy for migraine: what the research shows for IV magnesium and ketamine, and how they fit with standard migraine care.
A physician's look at IV therapy for migraine: what the research shows for IV magnesium and ketamine, and how they fit with standard migraine care. From HILLMED in Plano, Texas.
By Jerron C. Hill, M.D., Anesthesiologist and Founder of HILLMED
A migraine is not just a bad headache. Attacks can bring throbbing pain, nausea, vomiting, and sensitivity to light and sound, and they can last for hours or days. For people with frequent or severe attacks, migraine can take over work, family life and sleep.
It's no surprise that many patients ask about IV treatments: an infusion of magnesium, a vitamin drip, or ketamine. Some of these have real evidence behind them, and some have very little. Here is what the research shows, and how I think about it as a physician.
First: when a headache is an emergency
Call 911 or go to the nearest emergency department if you have:
A sudden, severe headache that feels like the worst of your life
Weakness, numbness, confusion, trouble speaking, or loss of vision
A headache with fever and a stiff neck, or after a head injury
A new pattern of headaches that is different from your usual migraines
These can be signs of a stroke, bleeding or infection, and they need emergency care, not an outpatient infusion.
How migraine is usually treated
Migraine care has two parts: treating attacks when they happen, and preventing them. Attacks are often treated with anti-inflammatory medicines, triptans, or newer migraine-specific drugs. People with frequent attacks may benefit from preventive medicines, including newer treatments that target a migraine pathway called CGRP.
When an attack doesn't respond at home, IV medications can help. A 2025 American Headache Society guideline reviewed IV and injected treatments for migraine attacks in the emergency department. It found the strongest evidence for IV prochlorperazine (an anti-nausea medicine) and for nerve blocks at the back of the head. Several other options, including IV ketorolac and metoclopramide, should also be offered when appropriate. [1]
If you have frequent migraines, a neurologist or headache specialist should be part of your care. The right preventive plan often matters more than any single infusion.
IV magnesium: some of the better evidence
Magnesium plays a role in how nerves and blood vessels behave, and some people with migraine have low magnesium levels.
A meta-analysis of 11 randomized trials with 948 participants found that IV magnesium relieved acute migraine attacks, with benefits seen within 15 to 45 minutes, at two hours, and at 24 hours. The same review found that oral magnesium supplements reduced how often and how severely migraines occurred. Some of the included studies had weaknesses in how they were designed. [2]
IV magnesium can cause flushing, warmth, and a drop in blood pressure. Excess magnesium can cause more serious side effects, especially in people with impaired kidney function. I do not infuse magnesium with IV ketamine at HILLMED. As part of my evaluation, a baseline magnesium level should be obtained before IV ketamine or IV vitamin therapy. The result helps guide safe treatment planning. Our guide to IV vitamin therapy explains how these infusions work.
Vitamin "cocktails" are popular for migraine, but there's little high-quality research on them as a group. We focus on ingredients with evidence and on your individual needs.
Ketamine: promising for some, but the evidence is limited
Ketamine blocks NMDA receptors, which are involved in how the brain processes and amplifies pain. That's why it has been studied for difficult headache conditions.
The research findings are mixed:
For a single migraine attack, the 2025 American Headache Society guideline concluded there isn't yet enough evidence to recommend for or against ketamine. [1]
For refractory chronic migraine, meaning headaches on most days that haven't responded to other treatments, some hospitals use multi-day ketamine infusions. In one 2026 study, 23 patients received a five-day inpatient infusion. Their migraine days fell from about 27 a month to about 22 a month a year later, and their thinking and memory did not measurably worsen. [3]
A 2026 practice advisory from the American Society of Regional Anesthesia and Pain Medicine on IV headache treatment in hospitals found that most options, including ketamine, are supported by limited evidence, because few randomized trials exist. [4]
These studies mostly involve hospital protocols lasting several days, which are different from outpatient infusions. For most people with migraine, ketamine is not a first-line treatment. It may be considered for carefully selected patients with refractory chronic migraine, ideally in coordination with their neurologist. Learn more about our approach to IV ketamine therapy.
Who may be a candidate
An evaluation for IV therapy may make sense if you:
Have a diagnosis of migraine from a physician, with no new or unexplained symptoms
Are already following a treatment plan, but still have attacks that disrupt your life
Have a neurologist or primary care physician who can coordinate care with us
Uncontrolled high blood pressure, significant heart or kidney disease, active psychosis (for ketamine) and pregnancy require careful assessment and may make treatment inappropriate.
What treatment looks like at HILLMED
Every patient starts with a consultation and a review of their headache history, medications and overall health. As part of my evaluation, a baseline magnesium level should be obtained before IV ketamine or IV vitamin therapy. I do not infuse magnesium with IV ketamine. If IV therapy is a good fit, infusions take place at our Plano clinic, with your blood pressure, heart rate and oxygen monitored throughout. We track your headache days and function over time, and adjust the plan with you.
Safety and medical supervision
Ketamine is FDA-approved as an anesthetic; its use for migraine is off-label. Common acute effects of ketamine include dissociation, temporary blood pressure increases, nausea, dizziness, and sedation, and monitoring continues until discharge criteria are met. Repeated exposure also warrants attention to misuse, urinary symptoms, and liver problems. [5] IV magnesium can cause flushing, warmth, and a drop in blood pressure, and it requires care in people with kidney disease. Arrange a driver after a ketamine infusion and follow the clinic's instructions.
A physician's perspective
In my clinical experience, I have found IV ketamine useful for patients with chronic migraine headaches that do not respond to conventional treatments. IV ketamine is not a first-line treatment and is not a cure for chronic migraine. It may improve quality of life by decreasing pain and reducing the frequency and duration of migraine headaches. My experience administering IV medications as an anesthesiologist informs our approach to evaluation, dosing, and monitoring.
No infusion replaces a good diagnosis, a preventive plan, regular sleep, hydration and attention to triggers. IV therapy works best as one part of that plan.
Frequently asked questions
Can an IV drip stop a migraine?
Some IV treatments can relieve an attack. IV magnesium relieved acute migraine within 15 to 45 minutes in a meta-analysis of 11 trials, and emergency departments use several IV medications with strong evidence. Results vary from person to person. [1, 2]
Is ketamine a good treatment for migraine?
IV ketamine is not a first-line treatment for migraine and is not a cure. In my clinical experience, it can be useful for selected patients with chronic migraine who have not responded to conventional treatments. It may decrease pain and reduce the frequency and duration of headaches, improving quality of life. Evidence remains limited, particularly for a single migraine attack. Treatment should be individualized and coordinated with a neurologist when appropriate. [1, 3]
Do vitamin drips like the Myers' cocktail help migraine?
They are popular, but there's little high-quality research on vitamin cocktails as a group. The evidence is stronger for specific ingredients, especially magnesium. [2]
Should I stop my migraine medications?
No. IV therapy is added to your existing plan. Don't change any medication without talking to the physician who prescribes it.
How often can I get IV therapy for migraine?
It depends on your diagnosis, how you respond and your overall health. We review your headache days and function with you and adjust the plan over time.
Does insurance cover IV therapy for migraine?
Coverage varies by plan, and IV therapy at a wellness clinic is often not covered. Contact HILLMED for current pricing and payment information, and check coverage directly with your insurer.
Learning more about treatment
IV therapy may help some people with migraine, especially when attacks keep breaking through despite standard care. The research is stronger for magnesium than for ketamine, and long-term benefit remains an area of study.
To learn more, book a complimentary teleconference consultation online or call HILLMED at 972.212.4341. We serve patients in Plano and throughout Dallas–Fort Worth, including Dallas, Frisco, Richardson, and McKinney.
About the author
Jerron C. Hill, M.D., is an anesthesiologist and the founder of HILLMED in Plano, Texas. He brings decades of anesthesia experience and nine years of clinical experience treating patients with IV ketamine to individualized, physician-supervised care.
Selected references
Robblee J, et al. 2025 guideline update to acute treatment of migraine for adults in the emergency department: The American Headache Society evidence assessment of parenteral pharmacotherapies. Headache. 2026;66(1):53–76.
Chiu HY, et al. Effects of Intravenous and Oral Magnesium on Reducing Migraine: A Meta-analysis of Randomized Controlled Trials. Pain Physician. 2016;19(1):E97–112.
Vinokur M, et al. Assessing Cognitive Function over Time in Patients with Refractory Chronic Migraine Who Received Ketamine Infusions. CNS Drugs. 2026;40(3):481–490.
Hoydonckx Y, et al. Practice advisory for intravenous management of headache disorders in hospitalized patients. Reg Anesth Pain Med. 2026;51(2):117–131.
Pfizer. Ketamine Hydrochloride Injection prescribing information.
This article is for education only and is not medical advice. Talk with your physician before starting or changing any treatment.
