Methotrimeprazine versus meperidine and dimenhydrinate in the treatment of severe migraine: a randomized, controlled trial.
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.
Stiell
I G
IG
Department of Emergency Medicine, Ottawa Civic Hospital, University of Ottawa, Ontario, Canada.
Dufour
D G
DG
Moher
D
D
Yen
M
M
Beilby
W J
WJ
Smith
N A
NA
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
D008614:Meperidine; D008728:Methotrimeprazine; D004111:Dimenhydrinate