Treatment of migraine in pregnancy

Sanchez-Landers M.; Leiva Reyes C.L.; Llanos J.J.; López M.; Mantilla-García J.A. · Revista Ecuatoriana de Neurologia (2024) · DOI: 10.46997/revecuatneurol33100089

Resumen

Introduction: Migraine is the most disabling primary headache. In pregnancy, its treatment is controversial due to possible side effects. Objective: Conduct an updated literature search on migraine treatment during pregnancy. Method: A search was carried out in PubMed, Scopus and Web of Science. Search terms were "pregnancy", "migraine" and "treatment". Search date ranged from 2018 to 2023. 315 articles were found; duplicates were eliminated with Rayyan QCRI (Rayyan Systems Inc ©) where selection was carried out by title and summaries, and full text. Finally, 21 articles were selected that included clinical trials, systematic reviews and narratives. Development: Acute and preventive therapy exists for migraine during pregnancy; non-pharmacological treatment is the first choice in both. For acute treatment, paracetamol, non-steroidal anti-inflammatory drugs only in the second trimester, triptans, metoclopramide and nerve blocks can be used. If the intensity is moderate and is not controlled with acute treatment, prevention is carried out with propranolol; Other drugs do not show safe evidence for use during pregnancy Conclusion: An appropriate choice of treatment, prioritizing non-pharmacological treatment and taking into account drug associations, is necessary in pregnant women whose migraine attacks do not subside.

Instituciones: Universidad Nacional de Trujillo