Focus on Women’s Health: Migraine Treatment During Pregnancy
By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD
Photo by Jonathan Borba [1]
At the Brain Health Institute, we understand that migraine doesn’t pause for pregnancy—and managing it safely matters more than ever. This week, we’re spotlighting a critical topic in women’s health that directly affects many of our patients: the safety of migraine treatment during pregnancy. Migraine is significantly more common in women—especially during their reproductive years—yet treatment decisions during pregnancy often involve uncertainty and concern [2]. A newly published study in Neurology (May 2025) offers timely, evidence-based insight into the long-term effects of triptan use during pregnancy—specifically its impact on child neurodevelopment. In today’s post, we break down the key findings and what they mean for clinical care [3, 4].
Triptans are a class of medications that are FDA approved as the first-line agents to treat acute migraine episodes with or without aura [5]. They work by targeting serotonin (5-HT) receptors in the brain to constrict blood vessels and reduce inflammation associated with migraine pain. Sumatriptan is the most studied of these medications and has a long track record of efficacy and safety. Triptans are widely prescribed for women of childbearing age, raising important questions about their safety during pregnancy—especially because they can cross the placenta and interact with serotonin pathways in the developing fetal brain. Except for sumatriptan, all triptans are contraindicated in pregnancy and breastfeeding [6].
Researchers from the University of Oslo and the University of Milano-Bicocca conducted a nationwide, registry-based cohort study using four comprehensive Norwegian health registries [3]. They followed over 26,000 pregnancies in women with diagnosed migraine from 2008 to 2023. Approximately 21,000 of these women used triptans in the year prior to or during pregnancy. The goal was to examine whether prenatal triptan exposure—alone or in combination with other migraine medications—was associated with an increased risk of neurodevelopmental disorders (NDDs) in children, including ADHD, speech/language delays, and learning disabilities. Children were followed for an average of eight years, with some tracked through age 14.
No significant increase in overall risk for neurodevelopmental disorders was found among children exposed to triptans in utero. When comparing children whose mothers had migraine but used no medication during pregnancy with those who had low or moderate triptan exposure, outcomes were statistically similar. Subgroup analysis revealed no elevated risk for ADHD, speech/language disorders, or learning disabilities. The study is notable for its long-term follow-up, large sample size, and comprehensive outcome tracking across multiple health databases. These findings are encouraging and support the conclusion that prenatal triptan exposure does not substantially increase long-term risks to child neurodevelopment.
During pregnancy, many continue to experience migraine attacks, and avoiding treatment out of concern for fetal safety can lead to undertreatment. This study offers reassuring evidence that, for many patients, the benefits of migraine treatment may outweigh potential risks when managed with thoughtful, individualized care and very close monitoring with your physician.
The authors did describe some limitations to this study. For example, prescription data does not confirm actual medication use. Some patients may have filled prescriptions but chosen not to take the medication. In addition, triptan users were more likely to be prescribed other medications (e.g., opioids or benzodiazepines), which could confound neurodevelopmental outcomes. The timing and dosage of exposure varied, and additional research is needed, especially for high-exposure or first-trimester cases. Thus, clinicians must continue to evaluate migraine treatment on a case-by-case basis, ideally incorporating preconception counseling and collaborative care with maternal-fetal medicine specialists.
If you are pregnant—or planning to become pregnant—and are living with migraine, know that safe and effective treatment options exist. Triptans, particularly sumatriptan, appear to pose no major long-term risk to your child’s neurodevelopment based on the current evidence. That said, always consult with your neurologist and OB-GYN to make personalized decisions based on your specific medical history and treatment needs [4].
At the Brain Health Institute, we’re here to support you with expert, compassionate care—whether you’re managing migraine, planning a pregnancy, or navigating both.
References:
- Photo by Jonathan Borba: https://www.pexels.com/photo/photo-of-hands-touching-baby-bump-4513731/
- Rossi MF, Tumminello A, Marconi M, et al (2022) Sex and gender differences in migraines: a narrative review. Neurol Sci 43:5729–5734. https://doi.org/10.1007/s10072-022-06178-6
- Camanni M, Van Gelder MMHJ, Cantarutti A, et al (2025) Association of Prenatal Exposure to Triptans, Alone or Combined With Other Migraine Medications, and Neurodevelopmental Outcomes in Offspring. Neurology 104:e213678. https://doi.org/10.1212/WNL.0000000000213678
- Shaw G (2025) Triptan Exposure During Pregnancy Does Not Increase Long-term Neurodevelopmental Outcomes. In: Neurology Today. https://journals.lww.com/neurotodayonline/fulltext/2025/06190/triptan_exposure_during_pregnancy_does_not.5.aspx
- Nicolas S, Nicolas D (2025) Triptans. In: StatPearls. StatPearls Publishing, Treasure Island (FL)
- Antonaci F, Ghiotto N, Wu S, et al (2016) Recent advances in migraine therapy. Springerplus 5:637. https://doi.org/10.1186/s40064-016-2211-8