• antiepileptic drugs

    Folic Acid is Essential for All Women of Reproductive Age

    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.

    Breastfeeding and Anti-Epileptic Medications

    Because breastfeeding has many psychological and medical benefits for both the mother and her child, many women would like to breastfeed. However, all medications taken by the mother are secreted into the breast milk. While various studies have addressed the short-term safety of antiepileptic drugs (AEDs) in nursing infants, none have systematically assessed the long-term effects of exposure to these drugs on cognitive development.

    Exposure to Valproic Acid and Increased Risk of Autism Spectrum Disorders

    There have long been concerns regarding the use of the anticonvulsant valproate (Depakote, VPA) 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 and other organ systems.  Multiple reports have also indicated that in utero exposure to valproate may also negatively affect cognitive development.

    More on Topiramate (Topamax) and Risk of Oral Clefts

    Earlier this year we reported on a possible association between first trimester exposure to topiramate (Topamax) and increased risk of cleft lip and palate.  In a recent study published by the American Journal of Obstetrics and Gynecology, researches drew upon data from two birth defect databases to further delineate the risks associated with topiramate exposure.

    Outcomes of Children Exposed to Antiepileptic Drugs in Pregnancy: No Good News for Valproate

    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. In addition, recent reports have indicated that in utero exposure to valproate may also result in lower IQ.

    From the North American AED Pregnancy Registry: The Newer Anticonvulsants Appear to Be Safer

    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). The North American AED Pregnancy Registry was established in 1997 for pregnant women in the United States and Canada at the Massachusetts General Hospital. The purpose of the registry is to obtain and publish information on the frequency of major malformations among infants whose mothers have taken one or more AEDs during pregnancy.

    Antiepileptic Drugs in Breastfeeding: Neurodevelopmental Outcomes

    Because breastfeeding has many psychological and medical benefits for both the mother and her child, many women would like to breastfeed.  However, all medications taken by the mother are secreted into the breast milk.  While various studies have addressed the safety of antiepileptic drugs (AEDs) in nursing infants, none have systematically assessed the long-term effects of exposure to these drugs on the cognitive development of children exposed to these agents through breastfeeding.  This is an especially important issue as it has been demonstrated that certain AEDs, most notably valproic acid, may negatively affect the developing brain, a process which occurs in utero and into the first few decades of the child’s life.

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