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Maternal (Expert Forum)
Pregnancy and migraine headaches
Patient medical question and answer from The Maternal and Child Health Forum. Health topic area and articles about newborn care
Pregnancy and migraine headaches
by Esther__0, Mar 07, 1999 12:00AM
I am 34 yrs old and have had migraine headaches since I was 19 yrs old. Until right before my pregnancy in 1995, the only medication I took was Fiorinal (plain and with codeine).During my first pregnancy, my headaches worsened, especially in my first trimester. The only thing that I took for them was two Aspirin-Free Excedrin...and that did not help. I was told that a max of 300 mg of caffeine daily is safe during pregnancy (Excedrin has 65 mg per caplet). Is that true? I have also tried Tylenol, Advil, and Alleve to no avail. I had preeclampsia and delivered my first child at 32 weeks. Now, I have begun taking Prometrium because I recently had a miscarriage at 7 weeks. Since we are planning on a pregnancy my question is: Could you give any recommendations on migraine headache medications and/or prophylactic medications that are safe to take during pregnancy? Thank you for any suggestions that you may have for me.
Doctor's Answer
by hfhsmdrcs, Mar 07, 1999 12:00AM
_
Dear Esther:
Migraine headaches are associated with contractions of blood vessels. They are highly variable in their frequency and quite unpredictable in pregnancy: some women get better and some worsen.
Migraine headaches may respond to non-medical therapies: lying down in a dark room; ice or warmth applied to the temple or neck areas.
Most medications, including pain medications, have not been scientifically evaluated during pregnancy. Hence, they do not carry a label of safety: rather, there are simply no reports of harm and the decision to use the medications is based on need.
Tylenol with codeine is a very common prescription because we have a lot of experience with the agent; it seems to work against a lot of pain types; other than constipation and drowsiness, the agent is well tolerated.
A few agents used in the treatment of migraine headaches (ergot compounds) are known to be harmful to pregnancy.
Progesterone has a quieting effect on blood vessels and may be helpful to migraine headaches.
300 mg of caffeine represents 3 cups of coffee and there are studies that suggest up to 3 cups of coffee had no influence on the outcome of pregnancy.
Keywords: migraine headache, pregnancy
This information isprovided for medical education and is not a consultation. If you have specific questions, please speak with your healthcare provider.
