Pregnancy lamotrigine

Nonteratogenic effects - There have been reports of decreased lamotrigine concentrations during pregnancy and restoration of prepartum concentrations after delivery. Dosage adjustments may be necessary to maintain clinical response. 

An epileptic patient who is taking phenytoin and lamotrigine to control her seizures is in the first month of pregnancy and definitely wants to have the baby. What vitamin supplement would be essential ... 

Tran TA, Leppik IE, Blesi K, Sathanandan ST, Remmel R. Lamotrigine clearance during pregnancy. Neurology 2002 59 251-5. 

Ohman I, Vitois S, Tomson T. Lamotrigine in pregnancy Pharmacokinetics during delivery, in the neonate, and during lactation. Epilepsia 2000 41 709-13. 

With current information, carbamazepine seems to be the safest drug for use during pregnancy. Data on lamotrigine (more recently introduced) are increasing but it has not been shown to be strongly associated with malformations. 

Plasma lamotrigine concentrations in one woman fell during pregnancy and increased about six-fold after delivery such changes could affect the chnical outcome (62). 

The outcomes of pregnancy in 53 women exposed to lamotrigine included 4 spontaneous abortions, 13 induced abortions (none because of a prenatally detected defect), 34 newborns without birth defects, and 2 newborns with unspecified defects (66). No information on co-medication was given, and more data are required for risk assessment. 

Tomson T, Ohman I, Vitols S. Lamotrigine in pregnancy and lactation a case report. Epilepsia 1997 38(9) 1039-41. 

Tennis P, Eldridge R. Six-year interim results of the lamotrigine pregnancy registry. Epilepsia 1999 40(Suppl 2) 196. 

Vajda FJ, Graham JE, Hitchcock AA, O Brien TJ, Lander CM, Eadie MJ. Is lamotrigine a significant human teratogen Observations from the Australian Pregnancy Register. Seizure 2010 19(9) 558-61. 

A literature search for congenital malformations after the use of lamotrigine during pregnancy yielded 10 studies and birth registers the risk of a major congenital malformation due to lamotrigine was 1 % [169 ]. 

A female infant was bom with micrognathia, low-set ears, facial dysmorphism, and unilateral radius aplasia to a mother who used lamotrigine 100 mg/day and oxcarbazepine 1200 m day during pregnancy for seizures [170 ]. 

Motamedi M, Karvigh SA, Sahraian MA, Azimi AR, Navardi S. Lamotrigine and twin pregnancy, incidental event or possible correlation Seizure 2009 18(8) 580-2. 

Holmes LB, Wyszynski DF, Baldwin EJ, Habecker E, Glassman LH, Smith CR. Increased frequency of isolated cleft palate in infants exposed to lamotrigine during pregnancy. Neurology 2008 70(22 Pt 2) 2152-8. 

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