Does caffeine help with migraine?

Matt, a 35-year-old lawyer, mentioned in passing that when he had a migraine, he took a couple of tablets of paracetamol with a double-shot espresso.

Caffeine is also available in combination over-the-counter analgesics. What is the evidence?

Clinical question

Is paracetamol with caffeine more effective than paracetamol alone for the treatment of migraine headaches?

What does the research evidence say?

Step 1: The Cochrane Library

The Cochrane Library contains a 2012 systematic review and meta-analysis that examines the use of caffeine as an analgesic adjuvant for acute pain (including migraines) in adults. 1

I conducted a search using TripDatabase and PubMed and could not find a better article to answer this question. The Australian-based eTG Complete guidelines does not mention caffeine at all.