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Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Safe Treatments while Nursing
(Message started by: sioux-z on Nov 28th, 2007, 9:28am)

Title: Safe Treatments while Nursing
Post by sioux-z on Nov 28th, 2007, 9:28am
Has anyone had a cluster cycle while nursing their baby?  Any safe treatments, other than O2?  Any safe preventatives?  

Title: Re: Safe Treatments while Nursing
Post by Melissa on Nov 28th, 2007, 12:17pm
I do not go into cycle while pregnant, but there is a lady here who does and I'm sure she'll be along to answer your question.

Title: Re: Safe Treatments while Nursing
Post by Bob_Johnson on Nov 29th, 2007, 8:14am
I've been digging around PubMed (major "warehouse" for med literature) and I'm surprised at how little I could find. This is one section that I found on Dr. Robbins' site (www.headachedrugs.com) to be used with caution because of the limitations outlined.
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Headache During Pregnancy and Breastfeeding

Migraine often diminishes during pregnancy. However, the headaches may at times be increased during the pregnancy, or the onset of migraine may occur during pregnancy. Organic causes for headache need to be considered and excluded in pregnant women with severe headaches. Treatment of the migraine or CDH during pregnancy consists of utilization of the non-medication techniques, such as ice and relaxation therapy, and judicious use of small amounts of medication. The abortive medications are predominantly used, with preventive therapy reserved for only the most resistant headaches. Although we attempt to maintain a drug free pregnancy, severe headaches require therapy, and if the physician does not adequately treat the headaches, most women will resort to OTC preparations. Women need to be informed of any risks to the fetus, as listed in the PDR or “Drug Facts and Comparisons”.

Acetaminophen is the primary abortive medication during pregnancy. This may be combined with small amounts of caffeine, such as aspirin-free Excedrin. Ice packs, a dark room, and relaxation exercises are utilized in addition. Limited amounts of NSAIDs such as ibuprofen or naproxen are also utilized, particularly in combination with small amounts of caffeine. Narcotics, particularly meperidine, codeine, or morphine, are also utilized. Aspirin in small doses may be used, but acetaminophen is preferred. Limited amounts of steroids, particularly Prednisone, can be used for severe intractable headache. Prednisone is preferable to dexamethasone. We cannot use ergotamine or triptans. Antiemetics may be used, particularly the over-the-counter (OTC) vitamin B6 or Emetrol. For more moderate to severe nausea, metoclopramide (Reglan) or prochlorperazine (Compazine) may be used. Dramamine and Antivert are also considered relatively safe. For extremely severe prolonged attacks of migraine, intravenous fluids, intravenous prochlorperazine (Compazine), narcotics, and steroids may all need to be utilized.

Prophylactic medication is occasionally necessary if headaches are very frequent and severe during pregnancy. Depending on comorbidities, SSRIs such as Prozac and Zoloft and b-blockers such as propranolol are usually utilized. Calcium channel blockers have also been used. Recent preliminary studies on SSRIs have indicated that they appear to be relatively safe. b-blockers, particularly in the first trimester, have been reported to cause intrauterine growth retardation, but have been considered to be relatively safe during pregnancy. We usually discontinue medication 3 weeks prior to delivery. During the first trimester we attempt to minimize or avoid medication, if possible. Women need to be completely informed as to potential side effects of any medication, as listed in major sources such as the PDR, and risks need to be completely understood and discussed.

Title: Re: Safe Treatments while Nursing
Post by sioux-z on Nov 29th, 2007, 11:11am
Thanks!  O2 is working better now that I'm trying a higher flow rate.  Unfortunately they want to come back pretty quickly w/o any meds along with the O2.  But I'm going to try a Red Bull with the O2 and see if that helps.  

I can deal with these things for a few months as long as they can be tamed by the O2.  

Title: Re: Safe Treatments while Nursing
Post by Bob_Johnson on Nov 29th, 2007, 1:18pm
Your experience with O2 is not unusual tho rarely mentioned here. Medical literature has commented on it, for some unknown % of people, that it blocks the attack which being inhaled and then the pain returns a few minutes after stopping.

With CH it's always a matter of running a series of personal trials to see what works for us. If I pulled out old files dating back 10-years, there would be a list of meds which have been suggested for a try but which failed to deliver. You "young kids" who have come along in a time of triptans don't know what suffering used to be....when there was almost nothing. <bg>

Title: Re: Safe Treatments while Nursing
Post by lionsound on Nov 29th, 2007, 5:20pm
Hello :)

I had Clusters while i was nursing and you need to be really careful and consult your pediatrician or ob/gyn or lactation specialist and  good neuro.

02 worked sometimes for me and when it didn't i used ice and showers and what ever other "tricks" i could think of.

Please ASK YOUR DOC of your choice about this, but SOME DOCS say that verapamil is an okay preventative. Mine gave me permission, but i chose not to use it because i didn't want it in my baby.. Also Magnesium and B2 as supplements might help(these I did and still do use).

I would caution against energy drinks unless you pump and dump the breast milk because you have no way of knowing how much of the "speed-em -up" stuff is getting into baby.

I  have no idea how old or big your baby is and that might make a difference in what you choose to do. How old is your baby?

I'm so glad the 02 works for you!
PF's !
-Rori

Title: Re: Safe Treatments while Nursing
Post by sioux-z on Nov 29th, 2007, 10:54pm
Thanks Rori.  Actually I am currently 38 weeks pregnant and have just started a cycle.  I'm still hoping somehow the cycle will break with labor.  I had a strange experience in June with CH's for just 2 weeks (they are usually a minimum of 2 months for me).  

I don't think I would consider Verapamil.  I used it with some success in my first cycle but it hasn't helped since then.  I hadn't heard of Magnesium and B2 but I'll talk to my neuro about those.

Thanks for all the info!



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