How to effectively manage primary Headaches in Pregnancy?
Effective Health Care Program has released pharmacologic and nonpharmacologic interventions to prevent or treat attacks of primary headaches (migraine, tension headache, cluster headache, and other trigeminal autonomic cephalgias) in women who are pregnant (or attempting to become pregnant), postpartum, or breastfeeding.
Evidence regarding the benefits and harms of all interventions in women who are pregnant (or attempting to become pregnant), postpartum, or breastfeeding is insufficient, or at best of low strength of evidence. Future research is needed to identify the most effective and safe interventions for preventing or treating primary headaches in these populations of women.of all interventions in women who are pregnant (or attempting to become pregnant), postpartum, or breastfeeding is insufficient, or at best of low strength of evidence. Future research is needed to identify the most effective and safe interventions for preventing or treating primary headaches in these populations of women.
- Prevention of primary headache in women who are pregnant (or attempting to become pregnant), postpartum, or breastfeeding with a history of primary headache
- Pharmacologic and nonpharmacologic interventions
- There is no evidence regarding the effectiveness of any pharmacologic or nonpharmacologic intervention in women who are pregnant (or attempting to become pregnant), postpartum, or breastfeeding.
- A single primary study provided insufficient (direct) evidence to make conclusions about the harms of topiramate when used for preventing primary headache during pregnancy, but use during pregnancy outside the primary headache context (indirect evidence) suggests increased risk of fetal/child adverse effects. Indirect evidence also suggests that other antiepileptics, such as carbamazepine, gabapentin, and valproate may have similar adverse effect profiles, but lamotrigine may have a low risk of adverse effects.
- Venlafaxine, tricyclic antidepressants (any), benzodiazepines (any), beta blockers (any), prednisolone, and oral magnesium use during pregnancy may have increased risk of fetal/child adverse effects, but calcium channel blockers (any, but nifedipine in particular) and antihistamines (any) may have a low risk of adverse effects (indirect evidence).
https://effectivehealthcare.ahrq.gov/products/headaches-pregnancy/research
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