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Ask Dr Charlotte: What migraine medications are safe to take during pregnancy?
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Each month Healthshare asks our followers to ask questions around a health topic. Our in-house GP, Dr Charlotte Middleton picks a handful of them and provides answers in a video. February topic was PREGNANCY AND BIRTH. -
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Dr Charlotte Middleton
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Special interests: integrative health (nutrition/vitamins/supplements), certified GAPS nutritional practitioner, womens and childrens health, endocrine disorders, weight loss, autoimmune disease View Profile
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In this video Dr Charlotte talks about the medications and treatments that are safe to use by migraine sufferers during pregnancy, and the ones that should be avoided unless your doctor decides otherwise.
Migraines are a vascular type of headache where you get an acute dilation of vessels in the brain, causing what initially can just start as a mild headache but quickly becomes a constant throbbing, pulsating pain (it can either be in the temples, front of the head or even the base of the head – often just the one side). It can also be associated with nausea, vomiting and photophobia, which is a sensitivity to light.
Some people get auras in the form of jagged or wavy lines, dots, flashing lights, tunnel vision or even blind spots (but the symptoms are very individual). People who experience migraines with auras prior to the pregnancy often do continue to have those migraines throughout the pregnancy.
When it comes to medications, unfortunately we only have a few that can be recommended during pregnancy, and that’s because, as you can imagine, it’s quite difficult to conduct randomised controlled trials on pregnant or breastfeeding women for ethical reasons. Most of the evidence that we have is circumstantial.
What we know that the tripton family of drugs is generally not recommended throughout pregnancy, because there’s not enough evidence to say that they are safe to use. There have been cases where they have been taken (in any trimester) and so far there has been a reassuring lack of side effects, but not enough to confidently say that they are safe to use during pregnancy. Aspirin and Nurofen are also not recommended.
Paracetamol is considered to be safe, most anti-sickness medications are ok and that’s something you will have to discuss with your doctor. Low dose Propranolol has also been used throughout the pregnancy, but the prolonged use is not generally recommended.
Something else that you can discuss with a headache neurologist is something called the occipital nerve injection where an anaesthetic or steroid is injected into the base of the scull to relax the muscle that surrounds one of the nerves that is known to cause the migraines.
Complementary therapies that we know can confer some benefit are things like increasing your intake of vitamin B6, B12 and B2, folic acid, vitamin D and magnesium; they all can sometimes help with headaches and migraines. One of the most important things you can do is to recognise and then avoid any known triggers (sometimes it’s great to keep a trigger and symptoms diary).
Other things that people talk about helping are cold towels, ice packs (even alternating cold packs and heat packs), cold showers, a nap, some exercises and relaxation.
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