If you’re a regular reader of the blog you know that I’ve posted on migraines before. For instance, you can check out the “Why We Do What We Do” on antiemetics (prochlorperazine and metoclopramide). Other excellent Pediatric Emergency Medicine educators have posted on the topic recently as well – see Sean Fox’s recent post on PedEMMorsels.
I wanted to take this opportunity to discuss an addition to the familiar “migraine cocktail” that is variably used in EDs – that addition, is diphenhydramine. Many Emergency Departments actually have this on their headache pathway by “default.” Allow me to present 3 reasons why, at least in pediatric patients, that you shouldn’t necessarily give benadryl as a matter of habit to every patient with a migraine.