What is the recommended treatment for migraine during pregnancy?
Amitriptyline and verapamil are used for migraine prophylaxis. Both have an FDA rating of pregnancy category C (risk to the fetus cannot be ruled out) and are not contraindicated for pregnant women. However, prophylactic migraine therapy should be avoided whenever possibly during pregnancy, especially in the first trimester. Often, migraine improves during the second and third trimesters of pregnancy, so acute therapy during the first trimester is preferred. If migraine continues to be disabling and occurs frequently during the second and third trimesters, prophylactic therapy could be considered, especially if the health of the mother and/or the fetus is compromised.