Maintenance treatment with a mood stabilizer during pregnancy can significantly reduce the risk of relapse in women with bipolar disorder; however, many of the mood stabilizers commonly used in this setting, including lithium and valproic acid, carry some degree of teratogenic risk. In contrast, lamotrigine (Lamictal) appears to be a much safer option for use during pregnancy.
Researchers analyzed a total of 21 studies describing pregnancy outcomes and rates of congenital malformations. Compared with disease-matched controls (n = 1412) and healthy controls (n = 774,571), in utero exposure to lamotrigine (LTG) monotherapy was not associated with an increased risk of major malformations.
Rates of miscarriages, stillbirths, preterm deliveries, and small for gestational age (SGA) neonates were similar in LTG-exposed pregnancies as compared to the general population.
While these data are not new and confirm previous studies, this report adds to our comfort in using lamotrigine during pregnancy.
Ruta Nonacs, MD PhD
Pariente G, Leibson T, Shulman T, Adams-Webber T, Barzilay E, Nulman I. Pregnancy Outcomes Following In Utero Exposure to Lamotrigine: A Systematic Review and Meta-Analysis. CNS Drugs. 2017 Apr 22.