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Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD): [12] This study found blood concentrations in breastfed infants of mothers taking carbamazepine, oxcarbazepine, valproate, levetiracetam, and topiramate were quite low, especially in relationship to the mother's level and what the fetal level would have been ...
Use of anticonvulsant medications should be carefully monitored during use in pregnancy. [94] For example, since the first trimester is the most susceptible period for fetal development, planning a routine antiepileptic drug dose that is safer for the first trimester could be beneficial to prevent pregnancy complications. [95]
The mechanism by which ethosuximide affects neuronal excitability includes block of T-type calcium channels, and may include effects of the drug on other classes of ion channel. The primary finding that ethosuximide is a T-type calcium channel blocker gained widespread support, but initial attempts to replicate the finding were inconsistent.
Enoxaparin is listed as Pregnancy Category B, meaning animal studies have failed to show harmful effects to the fetus and therefore are safe to use in pregnant women. [ 37 ] [ 39 ] However, pregnant women taking LMWH may not experience the full anticoagulant effect due to the nature of the medication compared to other anticoagulants (i.e ...
Some recommend avoiding polytherapy and maintaining the minimal dose possible during pregnancy, but acknowledge that current data fails to demonstrate a dose effect on the risk of birth defects. [30] [31] Data now being collected by the Epilepsy and Antiepileptic Drug Pregnancy Registry may one day answer this question definitively.
[8] [7] Use during pregnancy may result in harm to the fetus. [9] Primidone is an anticonvulsant of the barbiturate class; [7] however, its long-term effect in raising the seizure threshold is likely due to its active metabolite, phenobarbital. [10] The drug’s other active metabolite is phenylethylmalonamide (PEMA).
Contraindicated in pregnancy: Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
As is the case for all antiepileptic drugs, it is advisable not to suddenly discontinue topiramate as there is a theoretical risk of rebound seizures. Some studies have attributed loss of appetite and upper respiratory tract infection to topiramate, but studies have concluded their adverse events are not difficult to tolerate for most individuals.