Wednesday, March 12, 2008

Lamictal and your baby? Maybe not the greatest combination

It can be a quandary if you have epilepsy and you want a child...manage your seizures or have a healthy baby? It's important to work with a physician who knows epilepsy medications inside and out before you get to a point where this is even an issue.

For example, lamotrigine (Lamictal), a medication I know is a favorite in the population I work with because it is less likely to provoke polycystic ovary syndrome than other medications, was reported in the study referenced below, to cause hippocampal and cortical malformations. (The hippocampus is the brain's factual memory center and the cortex is where many "human" executive functions are organized and carried out.) These malformations did not occur at large, research-provoked doses, but rather at blood concentrations in the mother that would be considered clinically effective.

In the same study, topiramate (Topamax), phenobarbitol, and levetiracetam (Keppra) did not have the same effect.

No option will be 100% safe or perfect, that's just how it is with science/medicine. The best defenses you can have if you're a woman with epilepsy in your child-bearing years, is to have or find an epilepsy physician with whom you can develop a collaborative relationship...and to be informed.

Manent JB, Jorquera I, Franco V, Ben-Ari Y, Perucca E, Represa A. Antiepileptic drugs and brain maturation: Fetal exposure to lamotrigine generates cortical malformations in rats. Epilepsy Res. 2008 Feb;78(2-3):131-9. Epub 2007 Dec 31.

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