Methotrimeprazine versus meperidine and dimenhydrinate in the treatment of severe
migraine: a randomized, controlled trial.
Author(s): Stiell IG, Dufour DG, Moher D, Yen M, Beilby WJ, Smith NA.
Affiliation(s): Department of Emergency Medicine, Ottawa Civic Hospital, University of Ottawa,
Ontario, Canada.
Publication date & source: 1991, Ann Emerg Med. , 20(11):1201-5
STUDY OBJECTIVE: To compare the effectiveness of IM administration of
methotrimeprazine, a non-narcotic, nonaddicting phenothiazine derivative, with
that of a combination of meperidine and dimenhydrinate in the treatment of severe
migraine.
DESIGN: Double-blind, randomized, controlled trial.
SETTING: University hospital emergency department.
PARTICIPANTS: Consecutive adult patients with migraine who met eligibility
criteria.
INTERVENTIONS: Random allocation to receive IM injections of either 37.5 mg
methotrimeprazine (Levoprome, Nozinan) or 75 mg meperidine (Demerol) combined
with 50 mg dimenhydrinate (Dramamine, Gravol).
MEASUREMENTS AND MAIN RESULTS: The 37 patients in each group who completed the
study were similar in all demographic and clinical characteristics. There were no
statistical differences in pain intensity one hour after treatment, change in
pain intensity, or pain relief as measured on a visual-analog scale; need for
additional analgesia; persistence of nausea or vomiting; adverse effects; or
follow-up status, except for prolonged drowsiness, in the group receiving
methotrimeprazine.
CONCLUSION: Methotrimeprazine is comparable to meperidine with dimenhydrinate for
treating severe migraine and may be considered an effective, nonaddicting, IM
alternative to narcotics for the management of this problem.
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