Intravenous Metoclopramide and Diphenhydramine Combination Effective for Headache After Concussion in Emergency Department

A study published in Neurologyfound that, for people who experience moderate-to-severe headaches in the weeks after having a concussion (mild traumatic brain injury [mTBI]), a combination of metoclopramide (20 mg) and diphenhydramine (25 mg) given intravenously relieved headaches compared with placebo. In 160 participants who visited an emergency department because of a headache within 10 days of experiencing an mTBI, those who were given the combination (n=81) had an average pain decrease of 52% compared with 38% in those given placebo (n=79). 

“More research is needed to determine the most effective dose of metoclopramide, and how long to administer it, to see if people can get longer-term relief after they leave the emergency room,” said Benjamin W. Friedman, MD, Albert Einstein College of Medicine. “Also, future work may be able to determine whether early treatment with this medication can target other disruptive symptoms you may get after a head injury, like depression, sleep disorders, and anxiety.”