Lamotrigine

MONDAY, Dec. 2, 2024 -- For decades, it's been known that certain older medications women use to control epilepsy seizures can pose risks to a fetus. However, data now suggests that no such risk exists for newer-generation anti-seizure meds. “We need to balance making sure there is enough medicine on board to protect the mother and her developing fetus from seizures, but not too much where we're creating risk for the child,” explained study co-lead investigator Dr. Kimford Meador , a professor of neurology at Stanford University. Older medications such as valproate have been strongly linked to birth defects and cognitive issues in offspring. So, women with epilepsy have long been warned to stay off of these drugs while pregnant. However, seizure control is important, since seizures can also pose risks to the fetus and mother-to-be. New anti-seizure medications have been developed -- but do they pose any risk to the fetus? To find out, Meador's team tracked the language development of 387 children. Kids were tracked up to the age of 6. Of those, 298 had been born to women with epilepsy who took newer antiseizure medications while pregnant -- typically lamotrigine , levetiracetam or a combination of both drugs. "Children were tested on a variety of verbal abilities, including vocabulary and matching spoken words to pictures," according to a news release from the National Institute of Neurological Disorders and Stroke (NINDS), which funded the study. The result: No difference in language scores between kids exposed to the drugs in the womb and those who were not exposed. “What makes this study meaningful is that when you assess a child at 6, the tests are a lot more sensitive than at earlier ages, especially 2-year-olds," Meador noted in the news release. "There’s measurable impact on school performance and results are more predictive of adult cognitive ability." The new findings should reassure parents, since prior studies that had followed kids only up to age 2 or 3 had suggested that fetal exposure to high doses of levetiracetam might impair a child's cognitive skills. However, by 6 years of age, no differences were found, according to the new research. “Controlling seizures during pregnancy is an important part of prenatal care for women with epilepsy, but for years, the effects of newer antiseizure medications on their children was unknown,” noted Dr. Adam Hartman , program director at NINDS. “One major component of this study was correlating the cognitive abilities of children with maternal blood levels of the drugs. This opens the door to future work and might inform better dosing strategies," said Hartman, who wasn't involved in the study. Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

MONDAY, Nov. 25, 2024 -- Exposure to certain antiseizure medications (ASMs) in utero is associated with an increased likelihood of neurodevelopmental diagnoses, according to a study published online Nov. 15 in Nature Communications . Paul Madley-Dowd, Ph.D., from the University of Bristol in the United Kingdom, and colleagues created a cohort of 3,182,773 children, of whom 17,495 were exposed to ASMs in pregnancy, using routinely collected primary care data from the United Kingdom and nationwide Swedish registers to examine the long-term safety of ASMs. The researchers found that compared with children not exposed to ASMs, those exposed to valproate were more likely to receive a diagnosis of autism, intellectual disability, and attention-deficit/hyperactivity disorder. Children exposed to topiramate were 2.5 times more likely to be diagnosed with intellectual disability, while those exposed to carbamazepine were 1.25 and 1.30 times more likely to be diagnosed with autism and intellectual disability, respectively. Little evidence was found to indicate that exposure to lamotrigine in pregnancy was associated with increased odds of neurodevelopmental diagnoses. "The findings of this large-scale study suggest that topiramate, carbamazepine, and valproate, but not lamotrigine, use during pregnancy are associated with higher risks of neurodevelopmental conditions in exposed children," the authors write. "These observational associations translate to tangible absolute risk increases (ranging from 0.3 to 2.1 extra cases by age 12 per 100 children exposed in utero)." One author disclosed ties to the pharmaceutical industry; a second author disclosed ties to law firms and AlphaSights. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.