Central nervous system excitatory effects of meperidine in cancer patients

Ann Neurol. 1983 Feb;13(2):180-5. doi: 10.1002/ana.410130213.


The analgesic meperidine has been reported to produce signs of central nervous system excitation in human beings. To determine the relationship between signs and symptoms of central nervous system excitation and plasma levels of meperidine and normeperidine, we studied 67 patients receiving meperidine for the relief of postoperative or chronic pain. In 48 patients, excitatory effects ranging from mild nervousness to tremors, twitches, multifocal myoclonus, and seizures were directly correlated with accumulation of normeperidine in plasma. Evidence of compromised renal function occurred in only 14 of the 48 symptomatic patients, suggesting that renal dysfunction may contribute to but is not the sole factor in the accumulation of normeperidine or its relation to adverse neurological signs. In a second study we surveyed mood alterations in 47 patients receiving meperidine and 29 receiving other narcotic analgesics for postoperative pain. The repeated administration of meperidine was associated with adverse alterations in various elements of mood (e.g., apprehension, sadness, restlessness).

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Central Nervous System Diseases / chemically induced*
  • Child
  • Emotions / drug effects
  • Female
  • Humans
  • Male
  • Meperidine / adverse effects*
  • Meperidine / therapeutic use
  • Middle Aged
  • Neoplasms / drug therapy*
  • Palliative Care
  • Postoperative Period
  • Time Factors


  • Meperidine