Treatment Challenges for Migraine During Pregnancy: Brian Grosberg, MD, FAHS

WATCH TIME: 4 minutes

“This really emphasizes the need for the development and implementation of interdisciplinary guidelines both between headache specialists and women's healthcare specialists for optimally treating migraine during pregnancy.”

Research shows that there is an association between migraine and both maternal and fetal complications. Hence, understanding the awareness and levels of comfort for treatment with women’s healthcare providers is essential in research. Additionally, the knowledge of women of certain medications prior to conceiving is important to comprehend as they might benefit more from information related to nonpharmacological treatments that focus on lifestyle changes.

According to a recent survey of 92 women's healthcare providers conducted by the Hartford Headache Center, findings demonstrated a variety of levels of comfort for migraine treatment during pregnancy.¹ Notably, 26% of respondents reported they counseled women on migraine treatment during pregnancy before pregnancy contemplation, whereas over 35% counseled for migraine treatment once the patient became pregnant.

Respondents reported feeling somewhat or very comfortable with recommending (63%) or continuing (64%) acute treatments for pregnant patients with migraine. Highest comfort levels were observed for recommending of prescribing acetaminophen (100%) and prescribing (94% [85 of 90]) or continuing caffeine (91% [82 of 90]). Eighty-eight percent (n = 80) out of 91 respondents had higher levels of discomfort with recommending or prescribing triptans during pregnancy for migraine. In addition, 40% felt less comfortable with recommending preventive migraine treatments to pregnant patients, in comparison with 63% being somewhat or very comfortable with continuing preventive medications.

Brian Grosberg, MD, FAHS, medical director of the Hartford healthcare Headache Center in Connecticut, sat down with NeurologyLive® in a recent interview to provide an overview of the study along with the major highlights observed from the results. He also provided perspective on the significance of the findings for patients with migraine and treating clinicians, as well as the next steps in research.

REFERENCES
1. Verhaak A, Bakaysa S, Johnson A, Veronesi M, Williamson A, Grosberg B. Migraine treatment in pregnancy: A survey of comfort and treatment practices of women's healthcare providers. Headache. 2023;10.1111/head.14436. doi:10.1111/head.14436