My Research on Migraine Preventives and Pregnancy

I've written quite a bit about how my previous migraine specialist told me there weren't really any good options for migraine prevention while I was trying to conceive, was pregnant, or breastfeeding a baby.

Limited treatment options

As someone heavily invested personally and professionally in clinical research, I understood this - pregnant people are considered a vulnerable population, and there are not very often consents available for them to participate in research studies. This is understandable and infuriating, as someone who has been attempting to bear children for the last 4.5 consecutive years, including 3 miscarriages.

The challenge of trying to conceive

For me, personally, pregnancy and postpartum life weren't the challenges when it came to my migraines. It was the trying to conceive and failing part, the conceiving and miscarrying - every time my hormones fluctuated significantly, I was left with a grueling migraine that sometimes didn't respond to medication or abortive support.

I felt like this was just a cross I had to bear, so to speak.

Switching to a headache clinic

I recently switched my migraine care over to a headache clinic full of very trained, concentrated migraine specialists. During my intake appointment, I reviewed my history in full, including my frustration about how I hadn't been able to prevent my migraines from happening even when I could predict them coming from a mile away due to my trying to conceive.

This resulted in a surprised gasp, followed by a little laugh, and an "Oh, no no no," response from the physician.

For women who are or may become pregnant

It turns out that while some of the newer preventative medications haven't been tested for safety in pregnancy, there are, in fact, options of both medications and treatments available to individuals who struggle with migraines and are or may become pregnant.

My research on 3 migraine treatments

Of the several options I was given, I chose to pursue 3 - and I want to share those in case anyone who is trying to conceive or pregnant is looking for choices of their own:

1. A preventative supplement called EBH4 - my doctor recommended this immediately. Taking the place of my multivitamin, EBH4 is comprised of riboflavin, folate, magnesium, and CoQ10 and is intended for the metabolic management of migraines. Now, if you are pregnant and already taking a prenatal or folic acid supplement, you'll want to talk to your doctor about folic acid versus folate - the form and dose overall best for you.¹
2. Bystolic/Nebivolol - a beta-blocker that effectively lowers my blood pressure and can also be used as migraine prevention.²
3. Nurtec ODT - Originally approved as an abortive migraine medication, Nurtec ODT was approved in May 2017 as a migraine preventative when taken every other day. Now, this is a medication I will stop a few days before an IVF procedure or upon getting pregnant, as it's not been proven safe for pregnancy but has a very short half-life and will be out of my system quickly.³

Talk to your doctor

Now, of course, I'd never recommend you try a new medication without consulting the doctor who is supporting your efforts in trying to conceive or managing a pregnancy, but I wanted to include the things I learned about because there was so much lack of information on managing migraines during TTC/Pregnancy.