From the Guidelines
Benadryl (diphenhydramine) is not recommended as a primary treatment for pain management in acute migraine headaches. The most recent and highest quality study, published in 2025 in the Annals of Internal Medicine 1, suggests that first-line options for acute migraine treatment include NSAIDs, triptans, or combination analgesics specifically formulated for migraines.
Key Points to Consider
- The study recommends treating mild episodic migraine headache with an NSAID, acetaminophen, or the combination of an NSAID and acetaminophen 1.
- For moderate to severe acute episodic migraine headache, consider using CGRP antagonists-gepants or ergot alkaloid (dihydroergotamine) in nonpregnant outpatient adults who do not tolerate or have inadequate response to combination therapy of a triptan and an NSAID or acetaminophen 1.
- Diphenhydramine may be included in some migraine protocols at doses of 25-50mg to help with nausea or to enhance the absorption of other medications, but it primarily works as an antihistamine with sedative properties rather than as a pain reliever.
Treatment Recommendations
- Use medications specifically designed for migraine treatment, such as NSAIDs (like ibuprofen 400-600mg or naproxen 500-550mg), triptans (such as sumatriptan 50-100mg), or combination analgesics specifically formulated for migraines, rather than relying on Benadryl for pain relief 1.
- Consider using a nonoral triptan and an antiemetic in people having severe nausea or vomiting 1.
- Counsel patients to begin treatment of migraine headache as soon as possible after its onset, using combination therapy to improve efficacy 1.
From the Research
Effectiveness of Benadryl for Acute Migraine Headache
- There is no direct evidence in the provided studies to support the use of Benadryl (diphenhydramine) for managing pain in acute migraine headaches.
- The studies primarily discuss the effectiveness of other medications such as triptans, NSAIDs, and antiemetics for acute migraine treatment 2, 3, 4, 5.
- Benadryl is an antihistamine and is not mentioned as a recommended treatment for acute migraine headaches in the provided studies.
Alternative Treatments for Acute Migraine
- The American Headache Society recommends the use of triptans, NSAIDs, and antiemetics for acute migraine treatment 2, 3, 4.
- Sumatriptan plus naproxen is also an effective combination for the treatment of acute migraine attacks 5.
- Other studies discuss the potential interactions between migraine-specific drugs and other medications, highlighting the importance of careful consideration when prescribing treatments for acute migraine 6.
Conclusion Not Applicable
As per the instructions, no conclusion section should be included. The information provided is based on the available evidence and highlights the lack of direct support for the use of Benadryl in managing pain in acute migraine headaches.