Teratogenic effects of antiepileptic drugs
- 1 June 2010
- journal article
- review article
- Published by Informa UK Limited in Expert Review of Neurotherapeutics
- Vol. 10 (6), 943-959
- https://doi.org/10.1586/ern.10.57
Abstract
Many antiepileptic drugs (AEDs) have therapeutic applications that extend beyond epilepsy to include neuropathic pain, migraine headaches and psychiatric disorders. The risk of some AEDs has been clearly established, but for newer drugs, small sample sizes and polytherapy exposures preclude a conclusive determination of their teratogenic potential. Most women with epilepsy will require AED therapy throughout their entire pregnancy to control seizures; the vast majority of pregnancies in women with epilepsy have positive outcomes. A conservative estimate suggests that AED monotherapy doubles, and polytherapy triples, the risk for major congenital malformations. Furthermore, while evidence is still accruing, recent investigations suggest that exposure to select AEDs results in altered cognitive function later in development. There is no evidence to suggest that additional folic acid supplementation ameliorates the increased risk of congenital malformations conferred by in utero AED exposure.Keywords
This publication has 149 references indexed in Scilit:
- A prospective study of cognitive fluency and originality in children exposed in utero to carbamazepine, lamotrigine, or valproate monotherapyEpilepsy & Behavior, 2009
- Teratogenic Effects of Antiepileptic MedicationsNeurologic Clinics, 2009
- Antiepileptic drug use in women of childbearing ageEpilepsy & Behavior, 2009
- Valproic acid in pregnancy: How much are we endangering the embryo and fetus?Reproductive Toxicology, 2009
- Cognitive Function at 3 Years of Age after Fetal Exposure to Antiepileptic DrugsNew England Journal of Medicine, 2009
- Cognitive abilities and behaviour of children exposed to antiepileptic drugs in uteroCurrent Opinion in Neurology, 2009
- Pregnancy outcomes in women with epilepsy: A systematic review and meta-analysis of published pregnancy registries and cohortsEpilepsy Research, 2008
- Inhibition of histone deacetylase activity on specific embryonic tissues as a new mechanism for teratogenicityBirth Defects Research Part B: Developmental and Reproductive Toxicology, 2005
- The fetal hydantoin syndromeThe Journal of Pediatrics, 1975
- The Dysmorphogenic Potential of PhenytoinDrugs, 1974