Lamotrigine appears to be at least as safe as other antiepileptic drugs for use during the first trimester of pregnancy, according to a preliminary study.
As part of the International Lamotrigine Pregnancy Registry (beginning in 1992), P. Tennis and colleagues from the Worldwide Epidemiology Department, GlaxoSmithKline, Research Triangle Park, North Carolina, United States, have been prospectively monitoring patients who voluntarily reported taking lamotrigine during pregnancy. For this study, they report on the results as of September 2001, which included data on 168 patients who took lamotrigine monotherapy and 166 patients took who lamotrigine and at least one other drug during the first trimester of their pregnancy.
All these patients had a live birth with or without a major birth defect or an abortion with a major birth defect. Among women who took lamotrigine monotherapy during the first trimester of their pregnancy, 1.8 percent had a child with a major birth defect. Among women who took both lamotrigine and valproic acid during their first trimester, the major birth defect rate was ten percent. Finally, in women who took lamotrigine in combination with another drug that was not valproic acid during their first trimester, the major birth defect rate was 4.3 percent. No specific pattern of birth defects was found to be associated with specific drug use.
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