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Archive | anticonvulsants

Oxcarbazepine (Trileptal) and Pregnancy: Do We Have Enough Information?

  Last week in clinical rounds we discussed a case of a woman with bipolar disorder who was planning a pregnancy.  She had a long history of illness, experiencing primarily depressive episodes since her early 20’s.  The only mood stabilizer that seems to have worked for her has been oxcarbazepine (Trileptal) and she is currently […]

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Credit: Pregnant Woman from Wikimedia Commons

Why Are We Still Using Valproic Acid (Depakote) in Women of Childbearing Age?

  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, limbs, and genitals. Prenatal exposure to valproate may also result in […]

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More Data on Pregabalin (Lyrica) and Pregnancy

Pregabalin (marketed in the US as Lyrica) is approved by the US Food and Drug Administration for the treatment of epilepsy, fibromyalgia, and neuropathic pain.  It is also used off-label to treat psychiatric disorders, most commonly generalized anxiety disorder.  While it is not used as frequently as other anti-epileptic drugs, we do occasionally see women […]

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Is It Safe During Pregnancy? There’s An App for That

  January was Birth Defects Prevention Month, and MotherToBaby launched a free app  designed to provide evidence-based information to pregnant and breastfeeding women. There is Information on a broad range of medications, some herbal remedies, maternal illness, infections and vaccines, alcohol and other substances, occupational exposures, and other exposures (including things like lead, hair dye). […]

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Prenatal Antiepileptic Exposure Increases Risk for Malformations: Does High-Dose Folic Acid Reduce Risk?

The CDC, the U.S. Public Health Service, and the American College of Obstetricians and Gynecologists (ACOG) all recommend that every woman of reproductive age get 400 micrograms (400 mcg) or 0.4 milligrams of folic acid every day. Most multivitamins contain 400 micrograms or 0.4 milligrams of folic acid. Most prenatal vitamins have approximately 800 micrograms […]

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Topiramate and Pregnancy: More on Risk of Major Malformations

Topiramate (TPM, marketed as Topamax) is an antiepileptic drug which is also used for migraine prophylaxis, weight loss, and, less commonly, as a mood stabilizer.  Over the last few years we have seen several studies suggesting an increased risk of oral clefts in infants exposed to topiramate during the first trimester of pregnancy.  A recent […]

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