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lamotrigine and pregnancy

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  • some clinicians favour lamotrigine as the antiepileptic drug of choice in pregnancy - this opinion is based on the results of animal studies
  • data from the Lamotrigine Pregnancy Registry suggests that there should be caution in extrapolating the results from animal pregnancies to human pregnancies

NICE state with respect to use of carbamazepine or lamotrigine in antenatal and postnatal mental health (3):

  • if a woman who is taking carbamazepine or lamotrigine is planning a pregnancy or has an unplanned pregnancy, healthcare professionals should advise her to stop taking these drugs because of the risk of neural tube defects and other malformations in the fetus. If appropriate an alternative drug (such as an antipsychotic) should be considered
  • carbamazepine or lamotrigine should not be routinely prescribed for women who are pregnant because of the lack of evidence of efficacy and the risk of neural tube defects in the fetus
  • lamotrigine should not be routinely prescribed for women who are breastfeeding because of the risk of dermatological problems in the infant, such as Stevens-Johnson syndrome.

Reference:

  1. Prescriber 2001; 12 (18): 30-36.
  2. Reif-Eldridge R et al. Monitoring pregnancy outcomes after prenatal drug exposure through prospective pregnancy registries: a pharmaceutical company commitment. Am J Obst and Gyn 2000; 182: 159-63.
  3. NICE (2007). Antenatal and postnatal mental health

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