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Antiepileptics in pregnancy

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https://www.readbyqxmd.com/read/28814092/flow-cytometric-examination-of-apoptotic-effect-on-brain-tissue-in-postnatal-period-created-by-intrauterine-oxcarbazepine-and-gabapentin-exposure
#1
Z Erisgin, Y Tekelioglu
OBJECTIVE: For epileptics, pregnancy contains the balance between no seizure period and antiepileptic use having the least teratogenicity risk. The purpose is to analyse with flow cytometry the apoptotic effects on postnatal brain tissue caused by prenatal use of second generation antiepileptics oxcarbazepine (OXC) and gabapentin (GBP) having different effect mechanisms. METHOD: 30 (n = 5 each group) Wistar albino male rats (45-days-old) are used. First 3 groups are exposed to OXC (100 mg/kg/day), GBP (50 mg/kg/day), and saline, respectively on the 1st-5th prenatal days (preimplantation-implantation period) while the second 3 groups are exposed to the same substances on the 6th-15th prenatal days (organogenesis), respectively...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28762701/epilepsy-treatment-options
#2
REVIEW
Gerald Liu, Nicole Slater, Allen Perkins
The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on electroencephalography, abnormal brain imaging, nocturnal seizures, or an epileptic syndrome associated with seizures. In children, key risk factors are abnormal electroencephalography results, an epileptic syndrome associated with seizures, severe head trauma, and cerebral palsy...
July 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28758270/prescription-drug-use-during-pregnancy-in-france-a-study-from-the-national-health-insurance-permanent-sample
#3
Romain Demailly, Sylvie Escolano, Catherine Quantin, Pascale Tubert-Bitter, Ismaïl Ahmed
PURPOSE: To provide an up-to-date account of drug prescription during pregnancy in France from 2011 to 2014 using the permanent sample of the French national computerized healthcare database and with a focus on recommended supplementations, fetotoxic drugs and teratogenic drugs. METHODS: All pregnancies identified by the International Classification of Diseases, 10th Revision codes list in the hospitalization database, lasting more than 9 weeks of amenorrhea and whose delivery occurred between 01/01/2011 and 12/31/2014, were included...
July 30, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28729328/comparative-safety-of-antiepileptic-drugs-for-neurological-development-in-children-exposed-during-pregnancy-and-breast-feeding-a-systematic-review-and-network-meta-analysis
#4
Areti Angeliki Veroniki, Patricia Rios, Elise Cogo, Sharon E Straus, Yaron Finkelstein, Ryan Kealey, Emily Reynen, Charlene Soobiah, Kednapa Thavorn, Brian Hutton, Brenda R Hemmelgarn, Fatemeh Yazdi, Jennifer D'Souza, Heather MacDonald, Andrea C Tricco
OBJECTIVES: Compare the safety of antiepileptic drugs (AEDs) on neurodevelopment of infants/children exposed in utero or during breast feeding. DESIGN AND SETTING: Systematic review and Bayesian random-effects network meta-analysis (NMA). MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched until 27 April 2017. Screening, data abstraction and quality appraisal were completed in duplicate by independent reviewers. PARTICIPANTS: 29 cohort studies including 5100 infants/children...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28714604/antidepressants-antipsychotics-and-mood-stabilizers-in-pregnancy-what-do-we-know-and-how-should-we-treat-pregnant-women-with-depression
#5
REVIEW
Asher Ornoy, Liza Weinstein-Fudim, Zivanit Ergaz
Depression is generally treated with antidepressants, but may often need antipsychotics and mood stabilizers. We discuss the updated data regarding the safety in pregnancy of antidepressants and antipsychotics, except selective serotonin reuptake inhibitors, and their possible impact on the long-term development of the offspring. Several earlier studies demonstrated a slight increase in the rate of major anomalies following maternal tricyclic antidepressant treatment, but most current literature shows their relative safety in pregnancy...
July 17, 2017: Birth defects research
https://www.readbyqxmd.com/read/28672292/association-between-pregnancy-and-perinatal-outcomes-among-women-with-epilepsy
#6
Neda Razaz, Torbjörn Tomson, Anna-Karin Wikström, Sven Cnattingius
Importance: To date, few attempts have been made to examine associations between exposure to maternal epilepsy with or without antiepileptic drug (AED) therapy and pregnancy and perinatal outcomes. Objectives: To investigate associations between epilepsy in pregnancy and risks of pregnancy and perinatal outcomes as well as whether use of AEDs influenced risks. Design, Setting, and Participants: A population-based cohort study was conducted on all singleton births at 22 or more completed gestational weeks in Sweden from 1997 through 2011; of these, 1 424 279 were included in the sample...
August 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28657171/is-it-safe-to-use-lamotrigine-during-pregnancy-a-prospective-comparative-observational-study
#7
Orna Diav-Citrin, Svetlana Shechtman, Naama Zvi, Victoriya Finkel-Pekarsky, Asher Ornoy
BACKGROUND: Lamotrigine is a second-generation antiepileptic drug, also used as a mood stabilizer. Published data on its use in human pregnancy are largely derived from pregnancy registries. Pregnancy experience in most studies has been reassuring. However, data from the North American Antiepileptic Drug Pregnancy Registry suggested an increased risk for oral clefts. The primary objective of the study was to evaluate the rate of major anomalies after lamotrigine exposure during pregnancy compared with pregnancies of women counseled for nonteratogenic exposure (NTE)...
June 28, 2017: Birth defects research
https://www.readbyqxmd.com/read/28646257/effect-of-epilepsy-in-pregnancy-on-fetal-growth-restriction-a-systematic-review-and-meta-analysis
#8
REVIEW
Daijuan Chen, Lisha Hou, Xia Duan, Hongling Peng, Bing Peng
PURPOSE: Epilepsy is one of the most common neurological diseases during pregnancy. However, the influence of epilepsy on fetal growth is not understood. Thus, this study conducted a meta-analysis to determine the influence of epilepsy during pregnancy on fetal growth restriction (FGR). METHODS: BIOSIS, Medline, Embase, and PubMed databases were searched between January 2000 and January 2016. Without imposing language or regional restrictions, referenced articles were selected...
June 23, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28641176/epilepsy-and-pregnancy-for-healthy-pregnancies-and-happy-outcomes-suggestions-for-service-improvements-from-the-multispecialty-uk-epilepsy-mortality-group
#9
REVIEW
J P Leach, P E Smith, J Craig, M Bagary, D Cavanagh, S Duncan, A R C Kelso, A G Marson, D McCorry, L Nashef, C Nelson-Piercy, R Northridge, K Sieradzan, S Thangaratinam, M Walker, J Winterbottom, M Reuber
Between 2009 and 2012 there were 26 epilepsy-related deaths in the UK of women who were pregnant or in the first post-partum year. The number of pregnancy-related deaths in women with epilepsy (WWE) has been increasing. Expert assessment suggests that most epilepsy-related deaths in pregnancy were preventable and attributable to poor seizure control. While prevention of seizures during pregnancy is important, a balance must be struck between seizure control and the teratogenic potential of antiepileptic drugs (AEDs)...
June 1, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28590833/evaluation-of-a-decision-aid-for-women-with-epilepsy-who-are-considering-pregnancy-a-randomized-controlled-trial
#10
Amanda McGrath, Louise Sharpe, Suncica Lah, Kaitlyn Parratt
BACKGROUND: For many women with epilepsy (WWE), decision making about pregnancy is complicated by considerations such as the potential teratogenicity of antiepileptic drugs, offspring risk of epilepsy, seizure occurrence during pregnancy, and the challenges of parenting amidst poorly controlled seizures. OBJECTIVE: This proof-of-concept, randomized controlled trial aimed to evaluate a decision aid (DA) developed to help WWE decide if they should start or enlarge their families...
July 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28560798/vns-and-pregnancy-a-multicentric-experience-of-four-cases
#11
X Rodríguez-Osorio, F J López-González, Í Garamendi, J Rumià, A Matute, Á Prieto-González, M Carreño
BACKGROUND: Vagus nerve stimulation system (VNS) has been employed worldwide as adjunctive therapy in drug-resistant epileptic patients. Only nine previous pregnancies with six-positive outcomes have been reported in women with epilepsy treated with VNS since 1998. AIMS OF THE STUDY: To communicate the experience of pregnancies in women treated with VNS in our country. METHODS: Clinical data of four female patients treated with VNS during pregnancy and delivery in five gestations is described...
May 31, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28545329/psychotropic-drug-use-before-during-and-after-pregnancy-a-population-based-study-in-a-canadian-cohort-2001-2013
#12
Christine Leong, Colette Raymond, Dan Château, Matthew Dahl, Silvia Alessi-Severini, Jamie Falk, Shawn Bugden, Alan Katz
OBJECTIVE: To describe the extent of increase in use and the rate of continuation versus discontinuation of psychotropic agents before, during, and after pregnancy. METHODS: Rates of psychotropic use (antidepressants, anxiolytic/sedative-hypnotics, antiepileptics, antipsychotics, lithium, stimulants) among women with a hospital-recorded pregnancy outcome were assessed using databases at the Manitoba Centre for Health Policy. Rate of use was defined as ≥1 prescription over the total number of pregnancies in the 3-12 months before pregnancy, 0-3 months before pregnancy, during pregnancy, or 3 months after pregnancy...
August 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28543284/in-utero-oxcarbazepine-exposure-and-neonatal-abstinence-syndrome-case-report-and-brief-review-of-the-literature
#13
Chao-Yang Chen, Xing Li, Ling-Yue Ma, Peng-Hui Wu, Ying Zhou, Qi Feng, Yi-Min Cui
Oxcarbazepine is a second-generation antiepileptic drug that is used to treat partial seizures. Although it has been increasingly used in pregnant women, its fetal safety has not been fully validated. We describe a 12-hour-old neonate who developed neonatal abstinence syndrome (NAS) after intrauterine exposure to oxcarbazepine. The neonate was born via cesarean section to a mother who took oxcarbazepine 300 mg/day for treatment of seizures throughout her pregnancy. Approximately 12 hours after birth, the infant developed paroxysmal jitter, which mainly presented as increased excitability, irritability, limb shaking, and increased muscle tone...
May 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28486989/postnatal-treatment-using-curcumin-supplements-to-amend-the-damage-in-vpa-induced-rodent-models-of-autism
#14
Maha Al-Askar, Ramesa Shafi Bhat, Manar Selim, Laila Al-Ayadhi, Afaf El-Ansary
BACKGROUND: Valproic acid (VPA) is used as a first-line antiepileptic agent and is undergoing clinical trials for use as a treatment for many disorders. Mothers undergoing VPA treatment during early pregnancy reportedly show increased rates of autism among their offspring. The benefits of curcumin supplementation were investigated using an animal model of VPA-induced autism. METHODS: The study was performed using a rodent model of autism by exposing rat fetuses to valproic acid (VPA) on the 12...
May 10, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28424947/neurodevelopmental-effects-of-antiepileptic-drugs
#15
Marissa Kellogg, Kimford J Meador
Increasing evidence suggests that exposure to certain antiepileptic drugs (AEDs) during critical periods of development may induce transient or long-lasting neurodevelopmental deficits across cognitive, motor and behavioral domains. The developing nervous system may endure prolonged chronic exposure to AEDs during pregnancy (in utero) or during childhood, which can lead to neurodevelopmental defects such as congenital neural tube defects, lower IQ, language deficits, autism and ADHD. To date, valproate is the most widely recognized AED to significantly negatively affect neurodevelopment, and demonstrates greater adverse effects than any other AEDs that have been assessed...
July 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28385340/lacosamide-during-pregnancy-and-breastfeeding
#16
Simona Lattanzi, Claudia Cagnetti, Nicoletta Foschi, Leandro Provinciali, Mauro Silvestrini
BACKGROUND: The epilepsy treatment during pregnancy represents a balance between teratogenic hazard and seizure control. The aim of the study was to evaluate the safety and efficacy of lacosamide (LCS) during pregnancy and breastfeeding. METHODS: Patients referred to our Epilepsy Center for pregnancy planning who became pregnant while taking LCS were prospectively followed-up. Data on seizure frequency, side effects, pregnancy course, delivery and breastfeeding, birth outcome, congenital malformation and development of newborns were collected...
May 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28274007/facial-dysmorphism-an-unreported-teratogenicity-with-levetiracetam
#17
Jyotsana Gupta, Sandhya Jain, Shalini Rajaram, Neerja Goel, Bindiya Gupta
Levetiracetam (LEV) is a relatively newer anticonvulsant drug used to treat epilepsy and is approved by United States Food and Drugs Administration (USFDA). The drug binds to a synaptic vesicle glycoprotein and inhibits presynaptic calcium channels, thus reducing neurotransmitter release. Commonly reported side effects include drowsiness, weakness, unsteady gait, mood changes and loss of appetite. Like most other antiepileptics, it is a Category C drug in pregnancy. We report the first case of facial dysmorphism in the neonate of a mother taking LEV antenatally...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28243149/antiepileptic-drugs-prescribed-in-pregnancy-and-prevalence-of-major-congenital-malformations-comparative-prevalence-studies
#18
Irene Petersen, Shuk-Li Collings, Rachel L McCrea, Irwin Nazareth, David P Osborn, Phil J Cowen, Cormac J Sammon
OBJECTIVE: The aim of this study was to examine the prevalence of major congenital malformations associated with antiepileptic drug (AED) treatment in pregnancy. PATIENTS AND METHODS: Using data from The Health Improvement Network, we identified women who have given live birth and their offspring. Four subgroups were selected based on the AED treatment in early pregnancy, valproate, carbamazepine, lamotrigine and women not receiving AED treatment. We compared the prevalence of major congenital malformations within children of these four groups and estimated prevalence ratios (PRs) using Poisson regression adjusted for maternal age, sex of child, quintiles of Townsend deprivation score and indication for treatment...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28188601/sensitivity-of-the-uk-clinical-practice-research-datalink-to-detect-neurodevelopmental-effects-of-medicine-exposure-in-utero-comparative-analysis-of-an-antiepileptic-drug-exposed-cohort
#19
R A Charlton, A McGrogan, J Snowball, L M Yates, A Wood, J Clayton-Smith, W H Smithson, J L Richardson, N McHugh, S H L Thomas, G A Baker, R Bromley
INTRODUCTION: Electronic healthcare data have several advantages over prospective observational studies, but the sensitivity of data on neurodevelopmental outcomes and its comparability with data generated through other methodologies is unknown. OBJECTIVES: The objectives of this study were to determine whether data from the UK Clinical Practice Research Datalink (CPRD) produces similar risk estimates to a prospective cohort study in relation to the risk of neurodevelopmental disorders (NDDs) following prenatal antiepileptic drug (AED) exposure...
May 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28176327/women-treated-for-epilepsy-during-pregnancy-outcomes-from-a-nationwide-population-based-cohort-study
#20
Miia Artama, Jemina Braumann, Jani Raitanen, Jukka Uotila, Mika Gissler, Jouko Isojärvi, Anssi Auvinen
INTRODUCTION: Women with epilepsy (WWE) are generally treated as a risk group during pregnancy, but over 90% of pregnant WWE have favorable pregnancies. However, the risk of some pregnancy and delivery complications may be increased among WWE, especially those on antiepileptic drugs. MATERIAL AND METHODS: This nationwide, retrospective population-based cohort study includes WWE who gave birth in Finland during 1987-2008 (n = 1737) and the reference cohort of a random sample of women without epilepsy (n = 4357)...
July 2017: Acta Obstetricia et Gynecologica Scandinavica
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