The use of antidepressant drugs in pregnant women with epilepsy: A study from the Australian Pregnancy Register

Abstract

Co-medicating with ADDs in WWE taking AEDs does not appear to confer a significant added teratogenic risk, and it does not affect seizure control.

Polypharmacy in polymorbid pregnancies and the risk of congenital malformations—A systematic review

“…For example, the reported depression diagnosis could actually be a self‐diagnosis and not a physician‐diagnosed diagnosis. Furthermore, this study 26 might also be too small to detect the difference in prevalence of congenital malformation between groups.…”

“…Figures 2 and 3 illustrate all risk estimates reported in the studies 21–25 . Merlob et al, 27 Sivathamboo et al 26 and Ellfolk et al 25 did not report an OR in all comparisons. Overall, polypharmacy in pregnancy was found to be associated with an increased risk of congenital malformations compared with unexposed or monotherapy with OR ranging from 1.1 to >10.0 (95% CI 1.03–326) 21–23,25 .…”

“…The cohort study by Sivathamboo et al 26 investigated pregnant women with a diagnosis of epilepsy in an Australian register. They subdivided the pregnant women in groups based on whether they received anti‐epileptic drugs (AEDs), antidepressant drugs (ADDs) or had a diagnosis of depression, anxiety or bipolar disorder.…”

“…This study 27 may have been underpowered given that the prevalence of congenital malformation is around 5% 25 . Sivathamboo et al 26 is a telephone interview‐based cohort where the interview was not developed to answer the questions of the specific study. For example, the reported depression diagnosis could actually be a self‐diagnosis and not a physician‐diagnosed diagnosis.…”

Antiepileptic drugs and depression during pregnancy in women with epilepsy

“…At least in Australia, there has been considerable recent interest and media publicity regarding the frequency, recognition and management of depressive illness in the community. An earlier study based on data held in the Raoul Wallenberg Australian Register of Antiepileptic Drugs in Pregnancy (APR) failed to show an effect of antidepressant drug therapy on seizure occurrence during pregnancy in women with epilepsy 1 . The present paper reports a study carried out in women who were enrolled in a later version of the Register and has the aim of investigating whether antiepileptic drug (AED) treatment or seizure occurrence may have influenced the frequency of patient‐recognized depression during pregnancy.…”