E-drug: Migraine management (2)
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Dear E-Drug,
Joel Lexchin has forwarded interesting and important guidelines for
migraine management. In a survey on use of opioids for greater than 2
months for chronic non malignant pain in New South Wales, Australia it was
found that migraine accounted for 10% of all indications. Pethidine was
used in 16% of chronic non malignant pain cases given opioids. Pethidine IM
was the overwhelmingly preferred opioid for migraine and accounted for 43%
of all pethidine prescription in the survey. The average weekly dose for
all indications was 827mg. There is very little support for this approach
in the literature and indeed little discussion of the role (presumably very
limited) of opioids in migraine. This issue is causing us considerable
concern.
Ric Day
Richard DAY, MD FRACP
Professor of Clinical Pharmacology & Director Clinical Pharmacology &
Toxicology,
St Vincent's Hospital, Victoria St., Darlinghurst, NSW, Australia, 2010
Tel: 61-(0)2-9361-2331 Fax: 61-(0)2-9361-2724
Email: R.Day@unsw.edu.au
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