title: Methotrimeprazine versus meperidine and dimenhydrinate in the treatment of severe migraine: a randomized, controlled trial.
abstract: 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.
  
  
  METHODS
  Double-blind, randomized, controlled trial.
  
  
  METHODS
  University hospital emergency department.
  
  
  METHODS
  Consecutive adult patients with migraine who met eligibility criteria.
  
  
  METHODS
  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).
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Emergency Medicine, Ottawa Civic Hospital, University of Ottawa, Ontario, Canada.
authors.forename: I G
authors.initials: IG
authors.lastname: Stiell
authors.forename: D G
authors.initials: DG
authors.lastname: Dufour
authors.forename: D
authors.initials: D
authors.lastname: Moher
authors.forename: M
authors.initials: M
authors.lastname: Yen
authors.forename: W J
authors.initials: WJ
authors.lastname: Beilby
authors.forename: N A
authors.initials: NA
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D004111:Dimenhydrinate / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008614:Meperidine / Q000009:adverse effects / Q000627:therapeutic use*; D008728:Methotrimeprazine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D015999:Multivariate Analysis
chemical_list: D008614:Meperidine; D008728:Methotrimeprazine; D004111:Dimenhydrinate