Good news for people with migraine who take drugs before or during pregnancy: Study

“These results are encouraging for people with migraine, who may be taking these drugs before they even know that they are pregnant, and this is helpful information for their physicians, who can make more informed decisions about treating people with debilitating migraine attacks,” said study author Hedvig Nordeng, PhD, of the University of Oslo in Norway.

For the study, researchers used health registry records for the entire Norwegian population and identified 26,210 pregnancies in female participants with migraine at the start of pregnancy. Of those, 21,281 people, or over 80%, had taken triptans in the year before they became pregnant and 4,929 of those with migraine had not taken any triptans during that time. For those who took the drugs, researchers divided them into four groups: people who had low use of triptans and stopped using them before pregnancy (42%); people who increased using triptans six months before pregnancy and stopped using them in early pregnancy (31%); people who had moderate triptan use before pregnancy and continued into early pregnancy (21%); and people who used triptans before and during pregnancy (6%).

Then researchers followed the children born for an average of eight years and up until they were 14 years old for some. They checked health registries for diagnoses of neurodevelopmental disorders including autism spectrum disorder, behavioral disorders, learning and intellectual disabilities, speech and language and developmental coordination disorders and attention deficit hyperactivity disorder (ADHD).

Overall, 1,140 children, or 4.3%, were diagnosed with a neurodevelopmental disorder during the study. The most common were ADHD and speech and language disorders. A total of 2.2% of the children of people with the highest use of triptans were diagnosed with ADHD, compared to 2.1% of the children of people with migraine who did not use the drugs. A total of 1.1% of the children of people with the highest use of the drugs were diagnosed with speech and language disorders, compared to 1.0% of children of people who did not use the drugs. When researchers adjusted the results to account for other factors that could affect the risk of neurodevelopmental disorders, such as a parent having a neurodevelopmental disorder, folic acid intake or use of other drugs such as opioids or antidepressants, they found no increased risk for neurodevelopmental disorders among children exposed to triptans prenatally.

“Migraine affects almost one in five of people of childbearing age,” Nordeng said. “While symptoms often improve during pregnancy, about 8% of people experience worsening attacks during pregnancy, which can lead to increased risks of both maternal and fetal complications, so it’s vital to have treatment options available.”

A limitation of the study was that researchers did not verify that people took their migraine medications, only that they filled their prescriptions, so the actual drug exposure may be different than the estimates.  

Reference:

Hedvig Nordeng, and Angela Lupattelli Association of Prenatal Exposure to Triptans, Alone or Combined With Other Migraine Medications, and Neurodevelopmental Outcomes in Offspring, Neurology, https://doi.org/10.1212/WNL.0000000000213678.