My migraine patients start out thinking that they can’t do much to treat their migraines in pregnancy. After all, headache medications may harm the baby, so the only option is to turn off the lights and suffer, right? Wrong. The truth is, there is a lot you can do to treat migraines in pregnancy.
Some abortive options include:
- Tylenol Ultra Relief, which includes acetaminophen and caffeine and may be more effective than acetaminophen alone.
- Metoclopramide, which is a prescription anti-nausea medication that has strong evidence for treating migraines.
- Cranial nerve blocks, which is an injection of lidocaine near nerves in the scalp. This is a very effective treatment, and the only downside is that the relief may be temporary, so you may need repeat nerve blocks during pregnancy.
Some preventative options include:
- Several natural supplements have strong evidence for migraine prevention, such as magnesium citrate, vitamin B2, coenzyme Q10, vitamin D3, and melatonin. Now that’s a lot of pills to take at once, so I have combined all these ingredients into one convenient capsule called MigraineMD. Warning: Stay away from feverfew, which may increase the risk of preterm labor.
- Botox is a very effective and well-tolerated treatment for chronic migraine, and there is evidence that exposure to botulinum toxin (aka Botox) in the first trimester is safe. Many practitioners are continuing to give Botox throughout pregnancy despite the lack of safety data in the 2nd and 3rd trimesters, though many others do not.
- Nortriptyline and metoprolol are prescription migraine medications that are considered relatively safe in pregnancy if required.
Speak to your headache specialist about which options might be best for you.
-Neurologist and Co-Founder of NeuroNaturals