Meperidine. Older patients may be at greater risk of respiratory depression. Dosages required for effective analgesia may produce neurotoxic side effects, including seizures and delirium. Should be avoided in patients with delirium. There is a strong risk of abuse. Safer and more effective analgesics should be used.
Taper Guide. Opioids and opiates, in general, respond to rapid tapering covered by the use of clonidine or lofexidine. Both these drugs act on adrenergic receptors to damp down locus coeruleus hyperactivity. Clonidine also acts on imidazoline receptors which may be significant.
Initial Withdrawal Symptoms. Restlessness, runny nose, goose flesh, sweating, muscle cramps, insomnia, nausea, diarrhea, pain, and dilation of the pupils.
Enduring Withdrawal Symptoms. Depression, anxiety, and craving.