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. You can read more about those studies here:
Last week was National Folic Acid Awareness Week at the Centers for Disease Control (CDC), so this seems like a great time to remind women (and their caregivers) of the importance of folic acid in the prevention of birth defects. By taking the recommended dosage of folic acid daily, women will reduce the risk of neural tube defects by 50% - 70%. In addition, women who take folic acid supplements are less likely to give birth to a child with an autism spectrum disorder.
The European Medicine Agency (EMA)'s Pharmacovigilance and Risk Assessment Committee recently recommended strengthening the restrictions on the use of valproic acid in women of reproductive age. Over the last few years, we have seen a host of articles documenting the deleterious effects of valproic acid on the developing fetus:
Bupropion is commonly used to treat depression, and is also prescribed to support smoking cessation. Early data on bupropion-exposure during pregnancy raised concern for a possible increase in risk of malformations of the heart and large blood vessels in bupropion-exposed infants. Subsequent data from bupropion pregnancy registries has been reassuring, however, and do not demonstrate an overall increase in risk of cardiac defects following first trimester bupropion exposure. Although the overall risk of cardiac defects was not increased, the distribution of specific defects in these registries was unexpected in some ways. For example, the GlaxoSmithKline Bupropion Pregnancy Registry included two cases of coarctation of the aorta out of the 675 bupropion-exposed infants, compared to the rate of 6 cases per 10,000 births in the general population.
Benzodiazepines and non-benzodiazepine hypnotics are commonly used during pregnancy. However, there data regarding the reproductive safety of these agents has been somewhat mixed. Although initial reports suggested that there may be an increased risk of cleft lip and palate, more recent reports have shown no association between exposure to benzodiazepines and risk for cleft lip or palate. A new study shows no increase in the overall risk of malformations among children exposed to benzodiazepines.
This is the second part of a two part series on the use of antipsychotic medications during pregnancy. Â Read Part 1 here, which reviews data from the Australian antipsychotic registry.
This is the first part of a two part series on the use of antipsychotic medications during pregnancy. Atypical antipsychotic medications are commonly used for the treatment of schizophrenia and bipolar disorder. Despite the increasing [...]
Over the last few years, we have reported on several studies which have suggested an increased risk of certain types of cardiovascular malformations among children exposed to selective serotonin reuptake inhibitors (SSRIs) during pregnancy. The [...]
A recent study from researchers at the University of North Carolina reports that the children of depressed mothers treated with selective serotonin reuptake inhibitors (SSRIs) during pregnancy were more likely to develop Chiari type 1 malformations than were the children of mothers with no history of depression.
We would like to thank you for your continuing support of the National Pregnancy Registry for Atypical Antipsychotics (NPRAA) at the Center for Women’s Mental Health at Massachusetts General Hospital. We are grateful for all the referrals made to the Registry as our numbers continue to grow every day. Given the Registry’s successful enrollment, we are pleased to announce our plan to release preliminary data at an upcoming conference in June, the American Society of Clinical Psychopharmacology (ASCP) Annual Meeting.
