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The ergotamine derivative dihydroergotamine mesylate (DHE) and the opioid meperidine are commonly used in the emergency department to treat migraines. This multicenter, double-blind study compared the two drugs, both given intramuscularly, in 171 randomized patients (aged 18 to 60) presenting with an episode of migraine headache averaging 29 hours in duration. Both groups also received hydroxyzine for nausea.
At one hour, pain relief was identical with DHE and meperidine: On a 100-point scale, mean pain scores decreased from about 80 to 35 in both groups. Relief of nausea and improvement in functional ability were also similar in the two groups. About 40% in each group reported adverse effects: Dizziness and drowsiness were more common with …