What preventative medications for new-onset migraine headaches do not interfere with birth control (contraception)?

From the Guidelines

Yes, there are preventative medications for migraines that don't interfere with birth control, with topiramate, beta blockers, and CGRP monoclonal antibodies being viable options. According to the most recent and highest quality study, published in 2021 in Nature Reviews Neurology 1, beta blockers such as atenolol, bisoprolol, metoprolol, or propranolol, as well as topiramate, are recommended as first-line medications for migraine prevention. These medications do not affect birth control and can be effective in reducing migraine frequency and severity. Some key points to consider when choosing a preventative medication for migraines include:

• The medication's efficacy in reducing migraine frequency and severity
• Potential side effects and interactions with other medications
• The patient's medical history and comorbidities
• The patient's contraceptive needs and preferences As noted in the study 1, CGRP monoclonal antibodies can be considered as third-line medications, and they also do not interfere with birth control. It's essential to consult with a healthcare provider to determine the best course of treatment for individual patients, taking into account their unique needs and circumstances.

From the Research

Preventative Medication for Migraine

There are several preventative medications available for migraine treatment. The choice of medication depends on various factors, including the patient's medical history, presence of comorbidities, and potential side effects.

• The following medications have been shown to be effective in preventing migraines:
  • Beta-blockers (e.g., propranolol, metoprolol, timolol) 2, 3, 4
  • Anticonvulsants (e.g., topiramate, divalproex, valproate) 2, 3, 4, 5
  • Antidepressants (e.g., amitriptyline) 2, 3, 4
  • Other medications (e.g., gabapentin, naproxen, botulinum toxin) 3, 4, 6

Effect on Birth Control

Some migraine preventative medications can affect birth control or have potential adverse outcomes for infants of exposed mothers.

• Valproate should not be given to women of childbearing potential for migraine prevention due to the risk of adverse outcomes for infants 5.
• Topiramate may also lead to adverse outcomes for infants of exposed mothers 5.
• Other medications, such as propranolol and amitriptyline, do not have the same level of risk associated with birth control or pregnancy 2, 3, 4.

Alternative Options

For women who are concerned about the impact of migraine preventative medications on birth control, alternative options may be considered.

• Beta-blockers (e.g., propranolol, metoprolol) may be a suitable alternative 2, 3, 4.
• Other medications, such as gabapentin or naproxen, may also be considered 3, 6. It is essential to consult with a healthcare professional to determine the best course of treatment for individual patients, taking into account their specific needs and medical history 2, 3, 4, 6, 5.