Changes in antiepileptic drug-prescribing patterns in pregnant women with epilepsy

Abstract

The distribution of AED use likely reflects current prescribing patterns for PWWE cared for in USA tertiary epilepsy centers. This distribution has changed markedly since the turn of the century, but changes in the general population remain uncertain.

Fetal loss and malformations in the MONEAD study of pregnant women with epilepsy

“…Mean ± SD gestational ages for conceptions at enrollment were 13.7 ± 4.6 weeks in PWWE and 15.4 ± 3.9 weeks in HPW. The types of epilepsy and the distributions of specific AEDs used in PWWE have been described previously, 3 but are described here briefly. Most PWWE (74%) were on monotherapy, and most had focal epilepsy (62%).…”

“…This publication describes the occurrence of SAOs (i.e., spontaneous fetal loss and MCMs) in offspring of PWWE vs HPW in the MONEAD study, all of which are secondary outcomes for the MONEAD study. Details of the MONEAD methodology have been published previously, 3 but are represented here in part to allow the reader to more easily interpret the present findings. Participants were enrolled from December 2012 through January 2016 at 20 US epilepsy centers that are specialized in the management of women with epilepsy (WWE) during childbearing years.…”

Executive Summary: Management of epilepsy in pregnancy: A report from the International League Against Epilepsy Task Force on Women and Pregnancy

“…In one study on behavioural outcomes, an increase in certain Management of epilepsy in pregnancy behavioural problems was reported for children (mean age: 6.5 years), as rated by parents, (Huber-Mollema et al, 2019), however, this requires further investigation as there was no direct comparison to a control group. Lamotrigine and levetiracetam have become the most commonly used AEDs in pregnancy in tertiary epilepsy centres in the USA (Meador et al, 2018) and other countries (Kinney et al, 2018). However, data for even these two AEDs are inadequate.…”

Lamotrigine clearance increases by 5 weeks gestational age: Relationship to estradiol concentrations and gestational age

“…Lamotrigine (LTG) is approved for use as chronic therapy in patients with epilepsy and bipolar disorder. It is now the most commonly used antiepileptic drug (AED) across several pregnancy registries and studies . Major physiological changes during pregnancy can lead to significant changes in AED pharmacokinetics, causing possible interruptions in seizure stability.…”