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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.
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 ...
Heartburn is a common symptom of late term pregnancy during which up to 80% of pregnant women have experienced it by the end of their third trimester. [12] Heartburn often indicates the development of gastro-esophageal reflux disease (GERD), where the lower esophageal sphincter relaxes due to elevated progesterone levels causing increased ...
As with other anticonvulsants, ethosuximide carries a warning about use during pregnancy. Although a causal relationship with birth defects has not be established, the potential for harm to the baby is weighed against the known harm caused by a mother having even minor seizures.
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).
Taking topiramate in the first trimester of pregnancy may increase the risk of cleft lip/cleft palate in infants. [ 38 ] 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.
Oxcarbazepine is an anticonvulsant used to reduce the occurrence of epileptic episodes, and is not intended to cure epilepsy. [12] Oxcarbazepine is used alone or in combination with other medications for the treatment of focal (partial) seizures in adults. [3]