Lamotrigine may cause cleft palate

It is very important for women of childbearing age to know how medications they may be on might affect the health of their children. I've posted the statistics before regarding the percentage of births resulting from unintended pregnancies, so this warning goes out to ALL women, not just those intentionally trying to conceive.

In this case, the issue is Lamictal (lamotrigine). I work a lot with polycystic ovary syndrome. This is a medication often used with women needing anticonvulsants because it is one of the few in that category that does not seem to wreak havoc on the management of that syndrome. So the population I work with the most is especially sensitive to the risk I describe here.

The medical records of 684 women who had taken lamotrigine during pregnancy were reviewed for the incidence of birth defects. These results were compared to trends in children born to women who had not taken this medication during their pregnancy. The incidence of cleft palate-type birth defects was 10.4 times greater in the lamotrigine-exposed infants than it was in the non-exposed infants. The exposure noted to be most important was that which occurred in the first trimester of pregnancy.

Just be aware, if you're female and there is any chance at all that you might conceive, that you would benefit from working closely with any physician prescribing you any medication at all, for any reason, to be sure there is no unconsidered risk lurking beneath the issue being focused on with the writing of a prescription.

Holmes LB, Baldwin EJ, Smith CR, Habecker E, Glassman L, Wong SL, Wyszynski DF. Increased frequency of isolated cleft palate in infants exposed to lamotrigine during pregnancy. Neurology. 2008 May 27;70(22 Pt 2):2152-8. Epub 2008 Apr 30.