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my personal edition > epilepsy > news
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DGReview
Lamotrigine Use Appears Safe During Pregnancy
A DGReview of :"Epilepsy and pregnancy: lamotrigine as main drug used"
Acta Neurologica Scandinavica
12/22/2003
By Emma Hitt, PhD
The antiepileptic drug lamotrigine appears to be safe for use during pregnancy, findings from a small study suggest, but larger prospective studies are needed to confirm the results, the researchers conclude.
Previous studies indicated that women with epilepsy have a 2- to 3-fold higher risk of having infants with congenital malformations compared with the normal population. Several treatment options exist for patients with epilepsy, but the safest drug for treatment of pregnant women remains to be found.
In their report, Anne Sabers, Department of Neurology, Glostrup University Hospital, Danish Epilepsy Hospital, Glostrup, Denmark, and colleagues evaluated prospective data from 147 pregnancies. Of these, 35% of women used lamotrigine, 25% used oxcarbazepine, and 20% used valproate; 74% took the drugs as monotherapy. Folic acid supplementation was taken during first trimester by 80% of women.
Among infants born to women who were exposed to antiepileptic drugs, the overall risk of malformations was 3.1%. Two children were born with multiple malformations (both mothers were taking valproate) and two children had ventricular septal defects (one oxcarbazepine monotherapy, and one oxcarbazepine and lamotrigine).
Women treated with lamotrigine had a risk of malformations of 2.0% compared to 6.7% in women treated with valproate, but this difference was not statistically significant.
"The rate of malformations in the antiepileptic drug-exposed group (3.1%) was similar to that reported in infants of women with epilepsy without antiepileptic drug treatment and slightly increased compared with non-epileptic controls," Dr. Sabers and colleagues write.
They note that the number of pregnancies in the study was too low to draw valid conclusions about the individual drug toxicities during pregnancy. "However, based on the fact that published data on the teratogenic risk of new antiepileptic drugs are almost not existing, this preliminary study might be of general interest," they add.
"The results from the ongoing large and statistical adequate prospective multicentre studies are needed to provide sufficient information about the teratogenic risk, especially, of the increasing number of new [antiepileptics]," they conclude.
Acta Neurol Scand 2004;109:9-13.
"Epilepsy and pregnancy: lamotrigine as main drug used"
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