Teratogenicity of Second Generation Anti epileptic Drugs

When women with epilepsy want to start a family, they and their treating medical specialists are faced with a difficult problem. A pregnant woman with epilepsy needs proper treatment, both for her own health and that of her unborn child, as untreated epilepsy is known to increase the risk of congenital malformations. On the other hand, several (older) anti epileptic drugs are also known to have teratogenic properties. In a recent study, no additional teratogenic risk after exposure in the first trimester was found for women who were treated with one of the second generation anti epileptic drugs lamotrigine, levetiracetam, oxcarbazepine or topiramate in monotherapy.

The study used Dutch data from the International Registry of Anti epileptic Drugs during Pregnancy, EURAP. In total, 956 pregnant women using anti epileptic drugs in monotherapy were included. A comparison was made between women treated with monotherapy with either lamotrigine, levetiracetam, oxcarbazepine or topiramate and women treated with carbamazepine monotherapy. This study found no statistically significant differences in the rate of major congenital malformations (until one year after birth) and spontaneous abortions between the groups. Based on the results of this study combined with previous findings, treatment with one of these anti epileptic drugs may be continued during pregnancy if the epilepsy requires treatment.

To read the abstract:
Te Winkel B, Vorstenbosch S, van Puijenbroek E,. Teratogenicity of Second Generation Anti epileptic Drugs in EURAP Netherlands. Birth Defects Research 109:698-714 (2017)