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Lamotrigine

Teratogenicity of lamotrigine

Sarit Shor, Gideon Koren MD FRCPC, Irena Nulman MD

June 2007

ABSTRACT

QUESTION

One of my female patients has epilepsy and is currently receiving lamotrigine monotherapy. She has recently found that she is 6 weeks pregnant and is concerned about possible side effects of lamotrigine on her fetus. How should I advise her and should I switch to another antiepileptic drug?

ANSWER

Lamotrigine (LTG) has not been associated with an increased risk for major malformations in monotherapy in most available studies. Risk of major malformations has been suggested when LTG was taken in doses higher than 200 mg/d and when clefts not caused by any known syndrome have been associated with LTG treatment. Therefore, safety for the fetus cannot yet be proven or rejected, although the drug does not appear to be a major human teratogen.

QUESTION

Une de mes patientes souffre d’épilepsie et suit actuellement une monothérapie à la lamotrigine. Elle vient d’apprendre qu’elle est enceinte de 6 semaines et s’inquiète des effets secondaires possibles de la lamotrigine sur le fœtus. Quels conseils devrais-je lui donner et est-ce que je devrais lui prescrire un autre médicament contre l’épilepsie?

RÉPONSE

Selon la plupart des études publiées, la lamotrigine (LTG) en monothérapie n’a pas été associée à un risque accru de malformations majeures. On a laissé entendre la possibilité de risque de malformations importantes lorsque la LTG était prise à des doses de plus de 200 mg/j et lorsque des fissures non causées par des syndromes connus ont été associées à un traitement à la LTG. Par conséquent, il n’est pas possible encore de dire si la sécurité du fœtus est menacée ou non, quoique le médicament ne semble pas être un tératogène humain important.

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