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Top 10 Acute Migraine Treatment During pregnancy Medications for Migraines
If you’re pregnant — or planning to get pregnant soon — your doctor will generally advise
you to stay off medications unless they’re absolutely needed. Together, you’ll have to
weigh the potential effects of a drug on your unborn baby. In some cases, a decision will
need to be made based on scant or inconclusive research into a particular drug.
Many of the anti-migraine medications to treat or prevent migraine headache and its symptoms
should be avoided during pregnancy. That’s because they’ve been linked to birth defects
in babies. Other medications are associated with pregnancy complications. For instance,
some have been associated with bleeding, miscarriage, or intrauterine growth restriction (IUGR),
a condition in which the uterus and fetus don’t grow normally.
Acute Migraine Treatment Acute treatment aims to stop a migraine attack
after its first signs appear. Pain relievers, also called analgesics, may
help ease the intense pain of migraines. These general pain-relieving drugs, though, aren’t
specific to the migraine pain pathway: • Acetaminophen is generally considered
low-risk during pregnancy. • Nonsteroidal anti-inflammatory drugs (NSAIDs),
including aspirin, may carry a risk of bleeding and miscarriage if taken near the time of
conception. There is also a possible risk of blood pressure complications in the baby
if they are taken in the third trimester. Aspirin taken near delivery may lead to excess
blood loss in mothers during birth. • Most NSAIDs, including ibuprofen — sold
over the counter under the brand names Advil and Motrin — and naproxen — sold as Aleve
and other brands — don’t have enough controlled human research studies to assess all their
risks in pregnancy. • Narcotic pain relievers should generally
be avoided. There is a dual risk of addiction in both mothers and babies if they are used
for prolonged periods of time. Ergotamines work specifically for migraine
pain. But doctors advise against taking these drugs during pregnancy. They carry a risk
of birth defects, especially if taken in the first trimester. These drugs may also stimulate
labor contractions and premature birth. Triptans work specifically on the migraine
pain pathway. Triptans aren’t known to cause birth defects. But most research to date has
focused on animals, not humans. In 2008 The Journal of the American Medical Association
renewed its warning against combining triptans with two common classes of antidepressant:
• selective serotonin reuptake inhibitors (SSRIs)
• selective serotonin/norepinephrine reuptake inhibitors (SNRIs)
The combination carries the risk of a life-threatening condition called “serotonin syndrome.”
Other medications may be prescribed for relief of specific symptoms of a migraine during
pregnancy. For instance, antiemetics help soothe the vomiting and nausea that can accompany
a migraine. But many of the drugs typically used for migraine haven’t been adequately
studied in pregnancy, so their safety or risk to the fetus has not been determined.

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