Levetiracetam, lamotrigine and carbamazepine: which monotherapy during pregnancy?

Mari, Luisa; Placidi, Fabio; Romigi, Andrea; Tombini, Mario; Bianco, C.; Ulivi, Martina; Liguori, Claudio; Manfredi, Natalia; Castelli, Alessandro; Mercuri, Nicola Biagio; Izzi, Francesca

doi:10.1007/s10072-021-05542-2

Cited by 12 publications

(3 citation statements)

References 40 publications

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“…The other important comorbidity in our patient was epilepsy. Similar to BDI, the treatment of epilepsy during pregnancy is a difficult scenario because both the epilepsy itself and the antiseizure drugs (ASDs) can have harmful effects on both the mother and child [ 12 ]. Seizures pose a danger to pregnant women due to the risk of falls and abdominal trauma, along with the potential for fetal harm from hypoxemia and asphyxia.…”

Section: Discussionmentioning

confidence: 99%

Navigating the Complexity of a Bipolar Pregnant Patient With Multiple Comorbidities

Traugott,

Medina,

Parker

2024

Cureus

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Bipolar disorder I (BDI) is a psychiatric disorder characterized by the occurrence of at least one manic episode. Within the scope of neurological disorders, epilepsy and psychogenic nonepileptic seizures (PNES) share clinical features and can be differentiated using electroencephalogram (EEG). Substance use disorder is a condition defined by impaired control, risky use, social impairment, and addictive behaviors. We present the case of a 20-year-old pregnant woman with BDI associated with a history of epilepsy, PNES, and polyvalent substance use. The patient presented to the emergency department via the Baker Act involuntary hold multiple times throughout her pregnancy. Recognizing that the welfare of the mother and child was at risk, the court ordered a two-month commitment of inpatient psychiatric treatment at 30 weeks' gestation to ensure safe delivery. Comprehensive inpatient treatment, including risperidone, levetiracetam, lacosamide, haloperidol, diphenhydramine, lorazepam, and later clozapine, and a discharge plan for both the mother and the child are described in detail. Our goal is to contribute to the growing body of knowledge on the management of complex pregnant patients with psychiatric conditions in order to optimize outcomes for maternal and fetal health.

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Section: Discussionmentioning

confidence: 99%

Navigating the Complexity of a Bipolar Pregnant Patient With Multiple Comorbidities

Traugott,

Medina,

Parker

2024

Cureus

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“…People of childbearing age using valproate or carbamazepine should be instructed about these risks and contraceptive strategies must be implemented. Lamotrigine might be a safer option, with a risk of malformation estimated at 2% to 3%, but not much data are available …”

Section: Methodsmentioning

confidence: 99%

Diagnosis and Treatment of Bipolar Disorder

Nierenberg,

Agustini,

Köhler-Forsberg

et al. 2023

JAMA

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ImportanceBipolar disorder affects approximately 8 million adults in the US and approximately 40 million individuals worldwide.ObservationsBipolar disorder is characterized by recurrent episodes of depression and mania or hypomania. Bipolar depressive episodes are similar to major depressive episodes. Manic and hypomanic episodes are characterized by a distinct change in mood and behavior during discrete time periods. The age of onset is usually between 15 and 25 years, and depression is the most frequent initial presentation. Approximately 75% of symptomatic time consists of depressive episodes or symptoms. Early diagnosis and treatment are associated with a more favorable prognosis. Diagnosis and optimal treatment are often delayed by a mean of approximately 9 years following an initial depressive episode. Long-term treatment consists of mood stabilizers, such as lithium, valproate, and lamotrigine. Antipsychotic agents, such as quetiapine, aripiprazole, asenapine, lurasidone, and cariprazine, are recommended, but some are associated with weight gain. Antidepressants are not recommended as monotherapy. More than 50% of patients with bipolar disorder are not adherent to treatment. Life expectancy is reduced by approximately 12 to 14 years in people with bipolar disorder, with a 1.6-fold to 2-fold increase in cardiovascular mortality occurring a mean of 17 years earlier compared with the general population. Prevalence rates of metabolic syndrome (37%), obesity (21%), cigarette smoking (45%), and type 2 diabetes (14%) are higher among people with bipolar disorder, contributing to the risk of early mortality. The annual suicide rate is approximately 0.9% among individuals with bipolar disorder, compared with 0.014% in the general population. Approximately 15% to 20% of people with bipolar disorder die by suicide.Conclusions and RelevanceBipolar disorder affects approximately 8 million adults in the US. First-line therapy includes mood stabilizers, such as lithium, anticonvulsants, such as valproate and lamotrigine, and atypical antipsychotic drugs, such as quetiapine, aripiprazole, asenapine, lurasidone, and cariprazine.

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“…Europejski Rejestr Ciąż (EURAP) podaje, że częstotliwość napadów padaczkowych podczas ciąży pozostaje niezmieniona u 63,6% pacjentek, wzrasta u 17,3% oraz spada u 15,9% ciężarnych [16]. Konwencjonalne leki przeciwpadaczkowe wykazują działanie teratogenne u płodu.…”

Section: Zastosowanie Lewetiracetamu W Leczeniu Padaczki U Kobiet W C...unclassified

Levetiracetam – known and possible applications

Walczak¹,

Patrycja²,

Sylwia³

et al. 2023

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Zastosowanie lewetiracetamu w leczeniu napadów padaczkowych jest dobrze znane w literaturze. W tym artykule dokonano przeglądu zastosowań danego leku w leczeniu schorzeń neurologicznych oraz potencjalnych kierunków badań nad tym lekiem a także literatury dostępnej w bazie PubMed, używając następujących słów kluczy: „lewetiracetam”, „padaczka”, „stan padaczkowy”, „choroba Alzheimera”, „migrena”, „ból neuropatyczny”. Wyniki: Lewetiracetam jest lekiem przeciwpadaczkowym. Został zatwierdzony przez FDA (Food and Drug Administration) do leczenia adjuwantowego ogniskowych, mioklonicznych oraz toniczno-klonicznych napadów padaczkowych. Z literatury wynika, że jest także skuteczny w niezarejestrowanych wskazaniach: terapii migreny, epizodu manii w przebiegu choroby efektywnej dwubiegunowej. Pojedyncze badania wskazują na jego skuteczność w leczeniu choroby Alzheimera. Najczęstsze działania niepożądane występujące podczas leczenia lekiem są łagodne i szybko ustępują. Możemy zaliczyć do nich m.in.: senność, zawroty głowy, drażliwość, lęk czy zapalenia nosogardła. Lewetiracetam może być stosowany zarówno w populacji pediatrycznej, jak i u osób dorosłych. Zastosowanie lewetiracetamu stanowi interesujący kierunek w leczeniu wielu schorzeń z zakresu neurologii. Opisane w literaturze zastosowania leku wymagają przeprowadzenia dodatkowych badań na większej grupie pacjentów.

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Levetiracetam, lamotrigine and carbamazepine: which monotherapy during pregnancy?

Cited by 12 publications

References 40 publications

Navigating the Complexity of a Bipolar Pregnant Patient With Multiple Comorbidities

Navigating the Complexity of a Bipolar Pregnant Patient With Multiple Comorbidities

Diagnosis and Treatment of Bipolar Disorder

Levetiracetam – known and possible applications

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