When drug therapy is necessary and cannot be avoided during a pregnancy, the decision of what drug therapy is best may be difficult for the health care provider because the vast majority of drugs are classified as Pregnancy Category C. This classification indicates that information regarding the risk to the fetus is unknown. For ethical reasons, pregnant women are not included in drug studies, so most decisions regarding the safety of a particular drug are based on animal studies, available cases reports, or are theoretical and are based on pharmacokinetic properties. Fortunately, with the development of Pregnancy Registries, more information has been collected, analyzed, and is available regarding the safety of drugs during pregnancy. These registries have expanded in recent years allowing better determination of fetal safety for triptans and antiepileptic drugs (AEDs). The information assists health care providers in selecting optimal therapy for women seeking pregnancy or those already pregnant. This review presents the most recent information for the treatment and prophylaxis of migraines and seizures during pregnancy.
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