Anti-Epileptic Drugs - MGH Center for Women's Mental Health

Cognitive Development in Children Exposed to Levetiracetam (Keppra)

An increasing number of reproductive age women now take newer anticonvulsants for the treatment of mood and anxiety disorders; however, information regarding the reproductive safety of these medications is limited. A recent study has evaluated the cognitive and language development of children born to women with epilepsy exposed in utero to levetiracetam (LEV, Keppra) or sodium valproate (VPA, Depakote), as compared to control children born to women without epilepsy not taking medication during pregnancy.

By MGH Center for Women's Mental Health|2014-01-24T17:57:32-04:00January 14th, 2014|Anti-Epileptic Drugs, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

Levetiracetam (Keppra) and Pregnancy

While it is well-established that several of the older anticonvulsants, including valproate (Depakote), carry a significant teratogenic risk, less is known about the reproductive safety of the newer antiepileptic drugs (AEDs). A new report from the U.K. and Ireland Epilepsy and Pregnancy Registers suggests that the risk of malformations associated with levetiracetam (LVT, Keppra) use during pregnancy is low.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:11-04:00November 4th, 2013|Anti-Epileptic Drugs, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Prenatal Exposure to Antiepileptic Drugs Associated with Worse Developmental Outcomes

We have previously written about studies which indicate that prenatal exposure to antiepileptic drugs (AEDs), particularly valproic acid, may adversely affect the developing fetus. Numerous studies have documented long-term effects of antiepileptic exposure on cognitive functioning: prenatal exposure to AEDs has been associated with lower IQs, as well as lower scores on tests of executive functioning, memory, verbal and nonverbal abilities, in children at 6 yeas of age (Meador KJ et al, 2012). These deficits were the most prominent in children exposed to valproic acid.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:12-04:00September 27th, 2013|Anti-Epileptic Drugs, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

Valproic Acid and Pregnancy: FDA Issues Warning

There have been multiple recent reports indicating that the use of valproate during pregnancy may be associated with lower IQ, cognitive problems, and developmental delays in exposed children. This has prompted the FDA to issue a warning regarding the use of valproate-containing drugs, including Depakote and Depakene, during pregnancy:

By MGH Center for Women's Mental Health|2015-08-06T09:43:35-04:00May 21st, 2013|Anti-Epileptic Drugs, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Gabapentin (Neurontin) and Pregnancy

Despite the fact that gabapentin (Neurontin) is now used in a wide variety of clinical settings -- for epilepsy, pain management, anxiety, sleep disturbance – there is relatively little information regarding its reproductive safety. A prospective study from researchers at the Motherisk program reports on the outcomes of 223 pregnancies exposed to gabapentin and 223 unexposed pregnancies.

By MGH Center for Women's Mental Health|2015-08-06T11:47:38-04:00April 15th, 2013|Anti-Epileptic Drugs, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

Exposure to Valproic Acid and Increased Risk of Autism Spectrum Disorders

There have long been concerns regarding the use of the anticonvulsant valproate (Depakote, VPA) during pregnancy. First trimester use of valproate has been associated with a 3-5% risk of neural tube defects, as well as an increased risk of other malformations affecting the heart and other organ systems. Multiple reports have also indicated that in utero exposure to valproate may also negatively affect cognitive development.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:14-04:00March 4th, 2013|Anti-Epileptic Drugs, Autism Spectrum Disorder, Mood Stabilizers, Neurodevelopmental Disorders, Outcomes, Pregnancy & Medications|Comments Off

No Increase in Risk of Infant Mortality in Women Taking SSRIs During Pregnancy

While there has been a great deal of attention paid to the risks of exposure to antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs), during pregnancy, there has been comparatively little information on the risk of stillbirth and infant mortality in this population. In a recent population-based cohort study utilizing data from all Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden), researchers assessed the risk of stillbirth and infant mortality associated with the use of SSRIs during pregnancy.

By MGH Center for Women's Mental Health|2015-08-06T13:48:29-04:00January 9th, 2013|Anti-Epileptic Drugs, Neonatal Symptoms, Outcomes, Pregnancy & Medications, Pregnancy Outcomes|Comments Off

More on Topiramate (Topamax) and Risk of Oral Clefts

Earlier this year we reported on a possible association between first trimester exposure to topiramate (Topamax) and increased risk of cleft lip and palate. In a recent study published by the American Journal of Obstetrics and Gynecology, researches drew upon data from two birth defect databases to further delineate the risks associated with topiramate exposure.

By MGH Center for Women's Mental Health|2015-08-12T12:17:18-04:00August 13th, 2012|Anti-Epileptic Drugs, Mood Stabilizers, Pregnancy & Medications, Risk of Malformations|Comments Off

Outcomes of Children Exposed to Antiepileptic Drugs in Pregnancy: No Good News for Valproate

There have long been concerns regarding the use of the anticonvulsant valproate (Depakote) during pregnancy. First trimester use of valproate has been associated with a 3-5% risk of neural tube defects, as well as an increased risk of other malformations affecting the heart. In addition, recent reports have indicated that in utero exposure to valproate may also result in lower IQ.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:15-04:00June 26th, 2012|Anti-Epileptic Drugs, Mood Stabilizers, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off

From the North American AED Pregnancy Registry: The Newer Anticonvulsants Appear to Be Safer

While it is well-established that several of the older anticonvulsants, including valproate (Depakote), carry a significant teratogenic risk, less is known about the reproductive safety of the newer antiepileptic drugs (AEDs). The North American AED Pregnancy Registry was established in 1997 for pregnant women in the United States and Canada at the Massachusetts General Hospital. The purpose of the registry is to obtain and publish information on the frequency of major malformations among infants whose mothers have taken one or more AEDs during pregnancy.

By Ruta Nonacs, MD PhD|2025-06-26T09:08:16-04:00June 13th, 2012|Anti-Epileptic Drugs, Mood Stabilizers, Outcomes, Pregnancy & Medications, Risk of Malformations|Comments Off