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Integrative, Interventional, and Non-invasive Approaches for the Treatment for Migraine During Pregnancy

  • Episodic Migraine (S Nahas, Section Editor)
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Abstract

Purpose of Review

While most women with migraine improve during pregnancy, a subset may remain unchanged or even become more severe. Given the limited evidence for the use of prescription medications during pregnancy, many look to other treatment modalities. We seek to review complementary and integrative medicine, procedural interventions, and neurostimulation to empower women with safe and effective treatment options during pregnancy.

Recent Findings

Migraine treatment during pregnancy remains controversial. While evidence is limited, prospective and retrospective reviews, as well as clinical experience support the use of nutraceuticals, procedural interventions, and neurostimulation during pregnancy when the appropriate risks and benefits are weighed.

Summary

Empowering patients with information on complementary and integrative medicine, as well as non-systemic and interventional treatments, may help to reduce anxiety and headache burden during pregnancy. Various nutraceuticals have shown promise for the preventive management of migraine. Non-systemic interventions such as trigger point injections and peripheral and sphenopalatine nerve blocks offer effective treatment options with minimal side-effects. Options for neurostimulation have expanded in recent years and may offer safe and effective non-pharmacologic options for the management of migraine. It is imperative that providers do not minimize migraine during pregnancy and become aware of the treatment modalities available to help guide women through this experience.

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Authors and Affiliations

  1. Medical Director of The Comprehensive Headache Center, 9969 S 27th St. Suite, 3000, Franklin, 53132, WI, USA

    Ashley Holdridge

  2. Medical Director of Craniofacial Pain and Women’s Neurology, Novant Health, Winston-Salem, NC, USA

    Megan Donnelly

  3. Medical Director of Westport Headache Institute, Westport, CT, USA

    Deena E. Kuruvilla

Authors
  1. Ashley Holdridge
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  2. Megan Donnelly
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  3. Deena E. Kuruvilla
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Correspondence to Ashley Holdridge.

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Conflict of Interest

Dr. Holdridge serves on the advisory boards for Amgen, Teva, and Lundbeck. She is on the speaker’s bureau for Allergan/Abbvie, Amgen/Novartis, Biohaven, Lilly, Lundbeck, and Teva pharmaceuticals. Dr. Kuruvilla serves on the advisory boards for Theranica, Allergan/Abbvie, Lilly, Amgen/Novartis. She is a consultant for Alphasites consulting, Cefaly, Neurolief, Theranica, Nowwhat media, KX advisors. She is on the speaker’s bureau for Allergan/Abbvie, Lilly, Amgen/Novartis, Biohaven, American headache society, CME meeting. She has provided clinical trial support for Cefaly and Neurolief. She is on the editorial board for Healthline and a contributing author for Headline and WebMD/Medscape. Dr. Johnson serves on the advisor boards for Lundbeck, Teva, and Lilly. She is on the speaker’s bureau for Allergan/Abbvie, Biohaven, Lundbeck, Lilly, and Teva pharmaceuticals.

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Holdridge, A., Donnelly, M. & Kuruvilla, D.E. Integrative, Interventional, and Non-invasive Approaches for the Treatment for Migraine During Pregnancy. Curr Pain Headache Rep 26, 323–330 (2022). https://doi.org/10.1007/s11916-022-01028-8

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