![]() The location of the injection depends on the type and location of the patient’s migraine. These local injections of a substance like lidocaine or bupivacaine are injected into the scalp to target specific nerves. Nerve blocks can give patients relief from migraine during pregnancy. Though they’re typically not used for prolonged amounts of time, these medications are safe in pregnancy. Some anti-nausea medications, including prochlorperazine, metoclopramide and diphenhydramine can also relieve migraine symptoms. “More recent studies have shown that sumatriptans or triptans are actually very safe in pregnancy and have not been associated with any congenital defects or pregnancy complications,” Dr. Despite older studies that cited concern for fetal growth restriction and increased blood loss at delivery, new research shows that it’s not necessary to stop using triptans while pregnant. Many women with migraine take triptans prior to pregnancy, but then decide to discontinue the prescription medication when they become pregnant or their provider recommends that they stop taking it. “I would have a patient be on one of these medications for about 48 hours, no more than that.” Prescription medications “These are things like naproxen, Toradol, ibuprofen, which we don’t recommend use in the first trimester or in the third trimester, but in the mid-second trimester are considered safe to use for a limited amount of time,” says Dr. Non-steroidal anti-inflammatories are another option for relieving migraine. ![]() In combination with non-medication options, it can be effective in preventing and managing migraine symptoms. Over-the-counter medications, like acetaminophen, are safe during pregnancy. With its low risk of side effects, it is safe to use during pregnancy. Magnesium: Magnesium is a supplement commonly used for migraine prevention.Grossman suggests about a cup to a cup and a half of coffee per day, with a daily maximum of 200 milligrams of caffeine. Caffeine: Many women decide to cut out caffeine completely when they become pregnant, but a low level of caffeine is considered safe and can help prevent migraine.“Typically a lot of patients are dehydrated and don’t even realize it,” says Dr. Hydration: Staying hydrated is important for all pregnant women, but especially for those with migraine.“And also, of course, the lowest dose possible that we can use in pregnancy and preconception is what we recommend.” Her first-line treatment is non-medication options, and she then layers in other treatments as needed. “I’m always telling my patients, either preconception or patients that are pregnant, that we recommend in general to use the number of different medications for anything that we’re treating,” Dr. The good news is there are safe options for migraine prior to and during pregnancy. ![]() For patients who use oral contraceptives to regulate their hormone levels and manage migraine, having a conversation about migraine treatment options may happen when they want to go off of birth control and start trying to conceive. ![]() Treatment Options During PregnancyĬertain medications used for migraine treatment and prevention are contraindicated for pregnancy, due to safety concerns for the developing fetus. Tracy Grossman, an obstetrician-gynecologist who has completed a fellowship in maternal-fetal medicine and earned a master’s in neuroscience, shares the range of treatment options available for pregnant patients with migraine. Because of these figures, it is believed that fluctuations in estrogen levels play a role in migraine development.ĭr. The rate of migraine among women is three times higher than it is for men. The highest incidence of migraine is between ages 18 and 44, which are also the year many women experience pregnancy. Women typically start to experience migraine attacks during adolescence, which aligns with when menstruation begins. Many women with migraine who are pregnant or considering pregnancy stop taking their migraine medications and assume they don’t have safe treatment options available-but this is simply not true. It’s important for providers who treat women during their reproductive years to be aware of treatment options that are safe during pregnancy. Treating Migraine During Pregnancy How to treat patients for migraine during pregnancy
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