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Higher Doses of Topiramate (Topamax) During Pregnancy, Increased Risk of Oral Clefts

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 large […]

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Lamotrigine and Pregnancy: Meta-Analysis Shows No Increase in Risk for Malformations

  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 […]

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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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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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By Ragesoss - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=4544244

You Asked: What Dose of Folic Acid for Pregnant Women Taking Lamotrigine (Lamictal)?

In our community of perinatal psychiatrists, we have recently seen many questions regarding the use of folic acid supplementation in women taking lamotrigine (Lamictal).  While all recognize that all women of childbearing age should receive folic acid supplementation, there is considerable variation regarding the dose that should be recommended for women taking lamotrigine (Lamictal). Folic […]

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Pregabalin (Lyrica) and Pregnancy: Preliminary Data

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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