Demerol is the trade name for the medication meperidine hydrochloride, a synthetic opiate. Demerol is indicated for the treatment of moderate to severe pain, but some patients may also take it for depression. Demerol was first approved by the Food and Drug Administration in 1942 and has been studied extensively in clinical trials and post-marketing research. In the October 2005 issue of the "British Journal of Anaesthesia," Dr. Ken Gillman reported that Demerol acts as an opiate analgesic as well as increases the overall availability of the neurotransmitter serotonin. The latter effect may play a part in why some patients take Demerol to treat depression. Demerol has proven generally safe and effective if taken as directed, but it can also cause several side effects ranging from mild to serious.
Central Nervous System Effects
Demerol is an opiate analgesic, which can cause several depressive and excitatory effects to the central nervous system. According to Drugs.com, the most common side effects in this area include lightheadedness, dizziness and sedation. Other nervous system effects may include euphoria, weakness, headache, muscle twitches, convulsions, hallucinations, disorientation and visual disturbances. Taken in moderate to high doses, patients may also experience slowed or labored breathing and reduced cardiac output. In addition, in the August 2004 report by the New South Wales Therapeutic Advisory Group, Dr. Robert Dowsett and associates stated that Demerol increased patients' risk for seizures significantly. The report also states that Demerol may cause anxiety, mood changes and over-reactive reflexes.
Itching
Demerol, like other opiates, causes a release of histamine, resulting in itchy skin. Dowsett and associates report that Demerol caused a significantly higher rate of itching compared to much stronger opiates, including morphine, fentanyl and sufentanil. Prior to administration, patients report much less itching if they are pre-medicated with common antihistamines such as diphenhydramine and cimetidine. The release of histamine-causing itching may also be seen as a marker for a patient's threshold to safe dosing. This is because of the dose dependent association between histamine release and cardiovascular events, including low blood pressure and systemic vascular resistance.
Tolerance and Dependence
One of the more serious possible side effects of taking Demerol is the potential for drug tolerance and dependence. The prescribing label for Demerol states that physical dependence is not unusual for patients taking opiates for long periods to treat chronic pain. Tolerance occurs when a patient requires larger and larger doses in order to achieve the same effect. When patients decide to stop taking Demerol, they should slowly taper off their dose in order to prevent serious withdrawal effects, which can include restlessness, tearing, runny nose, aches and pains, anxiety, weakness, cramps, diarrhea, and increased heart rate.
References
- "British Journal of Anaesthesia"; Monoamine Oxidase Inhibitors, Opioid Analgesics and Serotonin Toxicity; Dr. Ken Gillman; October 2005
- New South Wales Therapeutic Advisory Group: Use of Pethinidine for Pain Management in the Emergency Department; Dr. Robert Dowsett et al.; August 2004
- Drugs: Demerol Professional Patient Information
