National Migraine Centre
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Anyone pregnant and taking amitriptyline?

Hi there,

Ive been on amitriptyline for years now (75mg) for transformed migraine and chronic tension headaches. Im looking to have children but am finding it hard coming off the ami. I saw a neurologist recently and he said I had to come off it before having a baby. However, on my write up to my GP it says:

"I advised that she should gradually wean off Amitriptyline if she was considering some cases ami can be continued during pregnancy... generally its recommended that it be ceased because of the possibility (albeit, unlikely) of it having an adverse affect on the baby."

The (albeit, unlikely)n part was crossed out but I could of course still read it. So any ideas? I'm not fully confident in my neurologist tbh and am not sure he is totally up to date on current thinking and treatments for migraine sufferers.


6 Replies

Hello, I am currently pregnant and on amitriptyline. It's not an ideal situation but have spoken to both my neurologist and midwife team who feel that as I still have mild to moderate symptoms I should remain on the tablets. The worry is that if I came off it and my symptoms return full force I wouldn't be able to look after a baby! (I use to be bed bound for days at a time) It's a rock and a hard place :( I have been told although there has been no research into pregnant women and amitriptyline that my neurologist has not experienced any adverse affects on treating women on amitriptyline and their babies in his years of practice (I hope he is right!) it's a tricky one and is probably a situation that needs to be looked at on an individual basis. I have been very undecided about what's best to do and ideally would not be on it but feel I will have to follow the medical advice this time. I will be keeping my fingers and toes crossed it all works out :) in the future I hope to look at alternatives to amitriptyline but probably shouldn't try them out while I'm pregnant. Good luck in what you decide to do. If you do not have faith in your neurologist maybe you might be able to get advise from the national migraine centre or the migraine trust? Just a thought.

Take care.


I came off amitriptyline in 2002 because I wanted to have children and was concerned about risks. I did cut them out gradually and combined this with some other changes over time - diet, exercise, lifestyle. I was lucky to be able to spend a bit of time focussed on me. When I was pregnant my migraines stopped completely. My GP said this was not unusual. This was such a wonderful time! Also all the time I breastfed my daughter I had no migraines. I was so pleased that I wasn't taking any medication, but still had sumatriptan to take if I got an attack. I would not have taken sumatriptan during pregnancy and would have had to choose between breastfeeding and taking a tablet if necessary.

Having over a year migraine free was a great motivator to having more children! I now have four wonderful children aged 4 - 11 and have had four migraine free pregnancies (and I was able to cope with any amount of morning sickness and heartburn, knowing that I was migraine free).

Migraines have returned between pregnancies, but through changing my lifestyle, cutting out caffeine and sugar and generally looking after myself better I have taken back alot of control over my migraines. I've tried loads of different things along the way, it's been a long and turbulent journey BUT 2014 is my first year since being pregnant that I have not had to take any sumatriptan. Its in the cupboard if I need it and I don't go away without it. I get alot of headaches still. I take paracetamol+caffeine for some, but have a few days each month that are very difficult to function through and that I do not have medication for (sumatriptan is too much because it knocks me out, and paracetamol + caffeine doesn't make any difference), but ... no full blown migraines this year! When I think back to life before my first pregnancy, that's an unimaginable leap!

Children change your life in many wonderful ways, and helping me deal with migraine has been an additional, life-changing and unexpected change for me. Good luck and try to put some trust in your own body to help you through. You will be able to look after your baby whatever life throws at you and your baby may just be able to help you out too.

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LouG - it sounds as if your migraines are/were hormonally triggered, and that your 'few difficult days each month' are also hormonally related episodes, even if they don't turn into full blown migraines. I have suffered in a similar way with hormonal migraines for many years, and have also had 4 children, and found that my migraines and my health generally was better whilst I was pregnant and breast feeding. It took a long time to convince my doctor that my ill health was actually hormonal migraines, but I eventally saw a consultant neurologist who confirmed this. However, the consultant couldn't provide any suitable treatment to help the condition. I then went to the Migraine Clinic in London, and read a book by one of their doctors, and learnt that migraines are triggered by a build up of several factors, only one of which is hormones. It seems that for 'hormonal' migraines, it is the change in balance of the hormones that comes along, on top of other factors such as stress, tiredness, etc, and just tips the scales to trigger the actual migraine. I learnt that by reducing the other factors, the effect of the hormones became less likely to trigger a migraine.

Having said all that, I have had a migraine this week, triggered, I think, by a stressful event, on top of generally being unwell.

You are right that children bring many blessings!


Hi, yes I agree, it's always a mixture of different issues and hormones are undoubtedly a big factor. Before my first pregnancy though there was no monthly pattern to my migraine attacks. It was one of the questions I was frequently asked by doctors before pregnancy and at that time migraines were more regular and random. With the migraine changes I experienced during and after being pregnant, I also went back to the doctor to tell explain that there was clearly a hormone link, expecting to be presented with the magic cure for hormonal migraines! That was a disappointing day.

Migraines are so individual and I think it takes a long time to get to grips with everything that may or may not be a factor. Diet, sugar and water are big issues for me, and tightness in the neck, general posture, overtiredness, stress.... but the main one for me is the hope of being able to take back control. I now try to think of headaches as unwelcome house guests, who sometimes have to be tolerated, but all eventually go away and one day will leave me in peace for good.


Daisyrose, what was the name of the book you read (the one of the doctors in the Migraine Clinic in London). I have hormonal migraines too and would love to read this book.


Hi there! I was on Amitriptyline for chronic migraines before I got pregnant - a low dose of 20mg per night. I was told that migraines usually improve in pregnancy and to stop taking the amitriptyline. Unfortunately the migraines came back with a vengeance- I was getting 3 attacks a week and they were much more painful than usual. I was also getting an aura each time, (sight and speech problems) which I only got once a year before. So by my 12th week of pregnancy I begged my GP for help and he agreed to let me start the amitriptyline again. I am 29 weeks now and I'm getting an attack around once every 2 weeks now, and much less severe.


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