Epilepsy Talk

Pregnancy with Epilepsy — Medication Dangers | July 1, 2017

According to the Epilepsy Foundation, mothers taking seizure medication, risk birth defects of 4 to 8 percent — compared with 2 to 3 percent for all babies. Not much of a difference.

But the risk seems to be highest when multiple seizure medications are taken.

Yet, without medication, uncontrolled seizures may deprive the baby of oxygen.

Seizures can also increase the risk of miscarriage or stillbirth.

So, it’s important, as you know, to get the right balance.

Here are two links that might help you in the process:

The Antiepilepsy Drug (AED) Pregnancy Registry  http://www.aedpregnancyregistry.org/

North American Pregnancy Registry http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/seizure-and-epilepsy-medicines/seizure-medications-and

However, it’s important to keep in mind, there are no anti-seizure drugs that are 100 per cent without risk of causing birth defects.

But some anti-seizure medications appear to be more dangerous than others and your doctor may be able to avoid prescribing them.

Here’s what doctors know so far:

* Depakote and Depakene seem to carry the highest risk of damage to the baby, particularly neural tube defects, such as spina bifida.

* Phenobarbital or Depakote during pregnancy may affect future intelligence of the child, but this can occur with other AEDs as well.

*  Dilantin (Phenytoin) and barbiturates can cause cleft lip or palate, or other skull, face, or heart malformations.

*  Depakote (Valproic Acid) and, to a smaller extent Tegretol (Carbamazepine and Carbatrol), are linked to open spine problems.

*  Tegretol can also cause “minor defects,” such as fingernail malformations, or mild facial feature distortions, that often resolve by age five years.

*  Lamictal can also cause  breakthrough seizures during pregnancy. That’s because metabolism of Lamictal — as well as other antiepileptic drugs — increases during pregnancy. This can cause a drop in the level of anti-seizure medication in your system. If that level gets too low, you could have a seizure. But if your doctor prescribes a higher dose of Lamictal to make sure that you don’t have breakthrough seizures, there could be a higher risk of damage to your baby. So it’s a delicate balance.

The best rule is to use the single medicine that is most effective in treating your seizures, but with some bias toward the newer FDA category C antiepileptic drugs such as: Neurontin, Topamax, Zonegran, Trileptal, Lyrica, Keppra and Vimpat.

But make sure your doc is up to date on all the newest research.

And seek a “high risk” gynecologist. 

If you have any questions, check with the Epilepsy Foundation.

Best of luck to you!

Other articles of interest:

DNA Blood Test Gives Women A New Option For Prenatal Screening  http://www.npr.org/blogs/health/2015/01/26/368449371/dna-blood-test-gives-women-a-new-option-for-prenatal-screening?utm_source=npr_newsletter&utm_medium=email&utm_content=20150126&utm_campaign=dailydigest&utm_term=nprnews

Striking a Nerve: Epilepsy Drugs in Pregnancy http://www.medpagetoday.com/Neurology/Seizures/43719

New Findings On Women, Pregnancy, Epilepsy http://www.sciencedaily.com/releases/2013/12/131209132444.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fhealth_medicine%2Fepilepsy+%28ScienceDaily%3A+Health+%26+Medicine+News+–+Epilepsy+Research%29

To subscribe to Epilepsy Talk and get the latest articles, simply go to the bottom box of the right column, enter your email address and click on “Follow”

Resources:

http://central-pennsylvania.injuryboard.com/fda-and-prescription-drugs/increased-birth-defect-risks-in-two-fdaapproved-epilepsy-medications.aspx?googleid=295210

http://www.epilepsy.com/learn/treating-seizures-and-epilepsy/seizure-and-epilepsy-medicines/seizure-medications-and-0

http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy/art-20048417

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176305/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110845/

---