Isn’t It Time for Stricter Valproic Acid Warnings for Women of Reproductive Age?
Despite FDA warnings, valproate is still prescribed to women of reproductive age, placing children at risk for birth defects and neurodevelopmental disorders.
Essential Reads: Oxcarbazepine (Trileptal) and Pregnancy
Given limited data on the reproductive safety of oxcarbazepine, we would recommend using alternate medications during pregnancy, when possible.Â
Prenatal Valproic Acid Exposure and Poor School Performance in Older Children
 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 [...]
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. Â Over the last few years we have seen several studies [...]
You Asked: Gabapentin (Neurontin) and Pregnancy
While gabapentin (Neurontin) is now used in a wide variety of clinical settings — for epilepsy, pain management, restless leg syndrome, anxiety, and sleep disturbance – there is relatively little information regarding its reproductive safety. [...]
Topiramate (Topamax) in Pregnancy May Affect Fetal Growth
This is a paper I missed from 2014, but I think this study adds some important information to the review we posted on topiramate a few weeks ago.
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.
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.
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.
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.