EFFICACY AND SAFETY OF MAGNESIUM IN MIGRAINE PROPHYLAXIS IN PREGNANCY

Abstract

Background: Migraine is a common neurological disorder affecting women of reproductive age. Preventive treatment during pregnancy is challenging because many pharmacological agents are associated with potential fetal risks. Magnesium has been proposed as a safer alternative for migraine prophylaxis; however, evidence regarding its efficacy and safety during pregnancy remains limited. Methods: We conducted a systematic literature search using PubMed, Cochrane Library, and Google Scholar for studies evaluating the efficacy and safety of magnesium in migraine prophylaxis during pregnancy. Of 138 records identified, four studies met the inclusion criteria, comprising two systematic reviews, one retrospective cohort study, and one survey. Data on study characteristics, efficacy outcomes, maternal adverse effects, and fetal outcomes were extracted and analyzed. Results: The available evidence demonstrated inconsistent findings regarding the efficacy of magnesium for migraine prophylaxis during pregnancy. One retrospective cohort study reported significant reductions in migraine frequency, severity, and associated symptoms following magnesium therapy, whereas systematic reviews found insufficient evidence to support its routine use. Magnesium was generally well tolerated, with only mild gastrointestinal adverse effects reported. Although one systematic review suggested a possible association with neonatal mortality, this finding was based on indirect evidence and should be interpreted cautiously due to methodological limitations and potential confounding. Conclusions: Current evidence is insufficient to recommend magnesium as a standard prophylactic treatment for migraine during pregnancy. While magnesium appears to have a favorable maternal safety profile and may benefit selected patients, well-designed prospective randomized controlled trials are needed to establish its efficacy and fetal safety.