1/21/08 #1 - Pregnancy and Migraine treatment, genetic risks?

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  • Full Question:
    I am 36 years old and have been getting migraines since puberty. They have gotten more frequent and more severe in recent years. I take Imitrex and Frova when necessary; and/but I am considering beginning to take Propranolol preventively.

    I have never had children but would like to become pregnant in the next year or two. My questions are:

    1. How will pregnancy and post-pregnancy likely affect my migraines?
    2. Must I go without treatment while I am pregnant?
    3. and most importantly (!!) Is there any hypothesis or evidence out there that my tendency to Migraines will put my (future) child at risk for autism or any other neurological disorder (not including migraine itself, as I'm assuming there is genetic predisposition to the same condition)?

    Thank you!! Karyn.

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    Answer:

     

    Dear Karyn;

     

    The treatment of Migraines during pregnancy is, of course, directed by the obstetrician. All of the Migraine specific medications and even propranolol are category C. That means that if the benefit outweighs the risk, it is okay to use the medication. For my personal taste, I prefer to have women on NO medications over the first 45 days of the pregnancy when the baby’s organs are forming structurally. I also realize that over 50% pregnancies are not planned so that mama may not know she is pregnant until 30 days into the pregnancy. During the pregnancy, about 50% of women’s Migraines will decrease during the second and third trimester, so that is good news. After the pregnancy there is a danger of exacerbation or severe reoccurrence of Migraine, which has implications for breast-feeding and medications, of course. I am in favor of treating Migraines if they are present as long as the obstetrician is not nervous about it. Migraines that can have many comorbidities including depression, anxiety, bipolar disease, hypertension; these are not necessarily causes of Migraine nor do Migraines causes these disorders. They simply are seen in the same person simultaneously at times.

     

    There is no evidence that your having Migraines will predispose your child to any other neurological disorders. If Migraine is present on your side of the family only, there is a 50% chance that your child will inherit Migraine disease; if on both sides of the family, 75%.

     

    Good luck,
    John Claude Krusz and Teri Robert

     

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    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.

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    © Teri Robert and J.C. Krusz, 2007.

    Last updated January 21, 2008.

Published On: January 21, 2008