• Despite guidelines that recommend against opioid use as first-line treatment for migraine headaches,  meperidine (Demerol) is still administered in 36% of all migraine headache ED visits in the U.S.

• Meperidine's lack of efficacy, adverse effects such of seizure, and toxic metabolic accumulation all contribute to its use for migraine headaches being discouraged.

• A recent meta-analysis out of New York again supports the avoidance of using meperidine for migraine headaches, and instead, encourages clinicians to use anti-emetic and dihydroergotamine regimens.

References

• Friedman, et al. "The Relative Efficacy of Meperidine for the Treatment of Acute Migraine:  A Meta-analysis of Randomized Controlled Trials."  Annals of Emergency Medicine. December 2008; Vol. 52, No. 6; 705-13.