Document Detail


Antiepileptic drugs and pregnancy outcomes.
MedLine Citation:
PMID:  22711424     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The treatment of epilepsy in women of reproductive age remains a clinical challenge. While most women with epilepsy (WWE) require anticonvulsant drugs for adequate control of their seizures, the teratogenicity associated with some antiepileptic drugs (AEDs) is a risk that needs to be carefully addressed. Antiepileptic medications are also used to treat an ever broadening range of medical conditions such as bipolar disorder, migraine prophylaxis, cancer, and neuropathic pain. Despite the fact that the majority of pregnancies of WWE who are receiving pharmacological treatment are normal, studies have demonstrated that the risk of having a pregnancy complicated by a major congenital malformation is doubled when comparing the risk of untreated pregnancies. Furthermore, when AEDs are used in polytherapy regimens, the risk is tripled, especially when valproic acid (VPA) is included. However, it should be noted that the risks are specific for each anticonvulsant drug. Some investigations have suggested that the risk of teratogenicity is increased in a dose-dependent manner. More recent studies have reported that in utero exposure to AEDs can have detrimental effects on the cognitive functions and language skills in later stages of life. In fact, the FDA just issued a safety announcement on the impact of VPA on cognition (Safety Announcement 6-30-2011). The purpose of this document is to review the most commonly used compounds in the treatment of WWE, and to provide information on the latest experimental and human epidemiological studies of the effects of AEDs in the exposed embryos.
Authors:
Bogdan J Wlodarczyk; Ana M Palacios; Timothy M George; Richard H Finnell
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review     Date:  2012-06-18
Journal Detail:
Title:  American journal of medical genetics. Part A     Volume:  158A     ISSN:  1552-4833     ISO Abbreviation:  Am. J. Med. Genet. A     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-23     Completed Date:  2012-11-05     Revised Date:  2013-08-13    
Medline Journal Info:
Nlm Unique ID:  101235741     Medline TA:  Am J Med Genet A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2071-90     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Department of Nutritional Sciences, Dell Pediatric Research Institute, The University of Texas at Austin, Austin, Texas 78723, USA. bwlodarczyk@austin.utexas.edu
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MeSH Terms
Descriptor/Qualifier:
Anticonvulsants / therapeutic use*
Female
Humans
Pregnancy
Pregnancy Complications / drug therapy*
Pregnancy Outcome*
Grant Support
ID/Acronym/Agency:
R01 HL085859/HL/NHLBI NIH HHS; R01 NS076465/NS/NINDS NIH HHS; R01 NS076465-01/NS/NINDS NIH HHS; U50/CCU913241//PHS HHS
Chemical
Reg. No./Substance:
0/Anticonvulsants
Comments/Corrections

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