Document Detail

Teratogenicity of antiepileptic drugs: state of the art.
MedLine Citation:
PMID:  15791143     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Information on the risks associated with antiepileptic drug (AED) use in pregnancy is necessary for a rational approach to the management of women of childbearing potential who have epilepsy. This reviews addresses recent reports on the risk for birth defects and impaired postnatal development attributable to prenatal exposure to AEDs.
RECENT FINDINGS: Some studies have indicated greater risk for birth defects as well as for lower verbal IQ in association with exposure to valproic acid, as compared with some other AEDs. The risk appears to be greater at doses above 800-1000 mg/day; lower doses may not carry higher risks than those associated with other AEDs. This observation is a cause of concern but more data are needed from prospective studies to assess the possible impact of confounding factors in order to clarify whether there is a causal relationship. Large-scale pregnancy registries have been launched and are expected to provide more conclusive comparative data on the most frequently used AEDs in the near future.
SUMMARY: Although further studies are needed, it appears reasonable to use valproic acid with caution in women with epilepsy who are planning to become pregnant, and to consider prescribing other equally effective and safer AEDs if they are available. The importance of seizure control during pregnancy must not be neglected, and any attempt to change treatment should be done before conception. Drug withdrawal during pregnancy should be avoided, and patients should be made aware that definitive evidence on the relative safety of AEDs is lacking.
Torbjörn Tomson; Dina Battino
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in neurology     Volume:  18     ISSN:  1350-7540     ISO Abbreviation:  Curr. Opin. Neurol.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-25     Completed Date:  2005-06-13     Revised Date:  2013-01-18    
Medline Journal Info:
Nlm Unique ID:  9319162     Medline TA:  Curr Opin Neurol     Country:  England    
Other Details:
Languages:  eng     Pagination:  135-40     Citation Subset:  IM    
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
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MeSH Terms
Anticonvulsants / adverse effects*,  contraindications
Congenital Abnormalities / etiology*,  prevention & control
Epilepsy / drug therapy*
Pregnancy Complications / chemically induced*,  prevention & control
Reg. No./Substance:
0/Anticonvulsants; 0/Teratogens

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