Headaches and women: treatment of the pregnant and lactating migraineur.

Migraine is a hormonally sensitive episodic headache disorder which may worsen during the first trimester, but usually improves during later pregnancy. Its treatment can be difficult because of the risks of injury to the fetus and newborn. These risks include teratogenicity, embryo mortality, fetal growth abnormalities, and perinatal effect. This paper reviews the effects of drugs on the fetus and newborn, their FDA classification, and their use during both pregnancy and lactation. Specific recommendations are given.