Headaches, during pregnancy

For tension headaches during pregnancy, nonpharmacologic approaches are first-line therapies, including exercise, biofeedback, and massage. If drug therapy is needed, acetaminophen is the first choice. 

Tension headaches have been less studied during pregnancy. Some women have increases in tension headaches during pregnancy, whereas 25% report improvement. Since psychological and musculoskeletal stresses play a key role in tension headaches, nonpharma-cological interventions serve as the treatment mainstay. ... 

Von Wald T, Walling AD. Headache during pregnancy. Obstet Gynecol Surv 2002 57 179-185. 

Toxicological studies have demonstrated that there are no important problems with fluconazole. Therapeutic doses of fluconazole may cause enzyme induction in the Hver. This suggests that interactions with other dmgs cannot be excluded. The side effects are similar to those of itraconazole and include nausea, headache, and vertigo. Occasionally, increased Hver enzymes may be noted. Like itraconazole, fluconazole is contraindicated during pregnancy. 

There are a number of reasons to be concerned about the potential safety of such widespread use of CAHP. These products are frequently used by vulnerable populations, including older adults, those with chronic disorders, children, and women during pregnancy and lactation (5 10). These products are also used by patients to treat a variety of chronic disorders that are difficult to medically manage (e.g., anxiety, depression, dementia and memory impairment, headache, weight loss, back disorders, chronic pain, prostatic hypertrophy, and cancer) (1,11,12). Choice of a particular product for a particular condition is usually based on the claims made for the product and anecdotes of historical use, rather than conclusive scientific evidence that establishes the safety and efficacy of a particular product for a particular condition. 

Proton pump inhibitors are extremely safe. Diarrhea, headache, and abdominal pain are reported in 1-5% of patients, although the frequency of these events is only slightly increased compared with placebo. Proton pump inhibitors do not have teratogenicity in animal models however, safety during pregnancy has not been established. 

Kallen B, Lygner PE. Delivery outcome in women who used drugs for migraine during pregnancy with special reference to sumatriptan. Headache 2001 41(4) 351-6. 

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