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Tag Archives | birth defect

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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USPSTF Emphasizes Periconceptual Use of Folic Acid to Prevent Birth Defects

Neural tube defects are among the most common major congenital anomalies in the United States and are associated with significant disability and death.  The risk of neural tube defects can be prevented with daily folic acid supplementation in the periconceptional period.  However, most women do not receive the recommended daily intake of folate.  January 5–11 […]

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Baby Belly from Wikimedia Commons

New Research from the CWMH: Prenatal Exposure to Atypical Antipsychotics Does Not Increase Risk of Malformations

The use of the newer “atypical” or second-generation antipsychotic agents continues to increase.  These medications are used to treat a spectrum of psychiatric disorders, including schizophrenia, bipolar disorder, major depression, PTSD and anxiety disorders.  Although most of the women taking atypical antipsychotics are of childbearing age, our information on the reproductive safety of these newer […]

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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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Baby Belly from Wikimedia Commons

SSRIs and Pregnancy: No Risk of Cardiovascular Malformations According to UK Study

Over the last few years, several studies have suggested an increased risk of certain types of cardiovascular malformations in children exposed to selective serotonin reuptake inhibitors (SSRIs) during pregnancy. The first reports suggested a link between cardiac septal defects and exposure to paroxetine; other, but not all, studies have also shown an elevated risk of […]

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Credit: Pregnant Woman from Wikimedia Commons

Venlafaxine and Duloxetine: Pooled Analysis Shows No Increase in Risk of Malformations

Women face difficult choices when deciding whether or not to continue psychiatric medications during pregnancy.  This choice can be especially difficult for women taking newer medications which lack adequate reproductive safety data.  While we have adequate data regarding the reproductive safety of most of the selective serotonin reuptake inhibitors (SSRIs), there has been less information […]

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You Asked: Is Duloxetine (Cymbalta) Safe To Use During Pregnancy?

You can find a more recent post on this topic here: Venlafaxine and Duloxetine: Pooled Analysis Shows No Increase in Risk of Malformations We receive a fair number of questions on the use of duloxetine during pregnancy.  Duloxetine (sold in the United Sates under the brand name of Cymbalta) is a serotonin-norepinephrine reuptake inhibitor (SNRI) […]

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Clinical Update: Use of Topiramate (Topamax) During Pregnancy

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:

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Avoid Valproic Acid in Women of Reproductive Age

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:

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