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valproate women

Rebecca L Bromley, Rebecca Calderbank, Christopher P Cheyne, Claire Rooney, Penny Trayner, Jill Clayton-Smith, Marta García-Fiñana, Beth Irwin, James Irvine Morrow, Rebekah Shallcross, Gus A Baker
OBJECTIVE: To investigate the effects of prenatal exposure to monotherapy levetiracetam, topiramate, and valproate on child cognitive functioning. METHODS: This was a cross-sectional observational study. Children exposed to monotherapy levetiracetam (n = 42), topiramate (n = 27), or valproate (n = 47) and a group of children born to women who had untreated epilepsy (n = 55) were enrolled retrospectively from the UK Epilepsy and Pregnancy Register. Assessor-blinded neuropsychological assessments were conducted between 5 and 9 years of age...
August 31, 2016: Neurology
Lakshminarayanapuram G Viswanathan, Parthasarathy Satishchandra, Bipin C Bhimani, Janardhan Yc Reddy, Batchu S Rama Murthy, Doddaballapura K Subbakrishna, Sanjib Sinha
OBJECTIVE: This study aims to discuss the prevalence of polycystic ovary (PCO) and Polycystic ovary syndrome (PCOS) in women with epilepsy (WWE) on valproate (VPA), carbamazepine (CBZ), or phenobarbitone (PB), drug naive WWE and women with bipolar affective disorder (BPAD) on VPA. MATERIALS AND METHODS: This prospective study included 190 women aged 18-45 years, who had epilepsy or BPAD (on VPA), and consented for study. Patients were grouped as Group 1 (n = 40): WWE on VPA, Group 2 (n = 50): WWE on CBZ, Group 3 (n = 50): WWE on PB, Group 4 (n = 30): drug naïve WWE, and Group 5 (n = 20): women with BPAD on VPA...
July 2016: Annals of Indian Academy of Neurology
Milana Okanović, Olga Zivanović
INTRODUCTION: Polycystic ovarian syndrome is a syndrome of ovarian dysfunction with the principal features of hyperandrogenism and polycystic ovary morphology. A large number of studies conducted on this topic have suggested a possible role of anticonvulsants, particularly valproate, in the pathogenesis or risk factors associated with polycystic ovarian syndrome. Bipolar treatment guidelines from Canada and the United States of America recommend valproate as the first line strategy in the acute treatment of bipolar disorder...
March 2016: Medicinski Pregled
Jacint Sala-Padró, Manuel Toledo, Estevo Santamarina, Montserrat González-Cuevas, Miquel Raspall-Chaure, Maria Sueiras-Gil, Manolo Quintana, Xavier Salas-Puig
BACKGROUND: Valproic acid (VPA) is an effective treatment in juvenile myoclonic epilepsy (JME), but concerns on its use during pregnancy are remarkable. Levetiracetam (LEV) is approved as second-line therapy, and used as monotherapy in clinical practice. Our objective was to analyze the outcome of LEV and VPA in JME. MATERIALS AND METHODS: We analyzed patients with JME attending our epilepsy unit between 2010 and 2014, including all patients treated with LEV and/or VPA at some point of the disease course...
July 19, 2016: Clinical Neuropharmacology
Harmony Raylen Abejuela, David N Osser
This revision of previous algorithms for the pharmacotherapy of generalized anxiety disorder was developed by the Psychopharmacology Algorithm Project at the Harvard South Shore Program. Algorithms from 1999 and 2010 and associated references were reevaluated. Newer studies and reviews published from 2008-14 were obtained from PubMed and analyzed with a focus on their potential to justify changes in the recommendations. Exceptions to the main algorithm for special patient populations, such as women of childbearing potential, pregnant women, the elderly, and those with common medical and psychiatric comorbidities, were considered...
July 2016: Harvard Review of Psychiatry
Hilda S Suto, Giordana C Braga, Giuliano R Scarpellini, Leandro I Takeuchi, Ana P Martins, João P Leite, Carolina S Vieira
OBJECTIVE: To evaluate neurologists' knowledge of contraceptive counseling for women receiving antiepileptic drugs (AEDs). METHODS: An interview-based survey was conducted from February 2 to June 30, 2015, among neurologists working in Ribeirão Preto, Brazil. Direct interviews were conducted using a questionnaire that assessed knowledge of the pharmacological interactions between various contraceptive methods and six AEDs (carbamazepine, phenobarbital, topiramate, phenytoin, lamotrigine, and valproate) on the basis of WHO medical eligibility criteria for contraceptive use...
September 2016: International Journal of Gynaecology and Obstetrics
Faruk Uguz, Verinder Sharma
OBJECTIVE: This review examined the safety of mood stabilizers in exposed breastfed infants. METHODS: PubMed was searched for English language reports between 1 January 1995 and 30 August 2015 by using combinations of key words breastfeeding, lactation, postpartum period, puerperium, mood stabilizers, lithium, lamotrigine, valproate, carbamazepine, and oxcarbazepine. Case reports, case series, and prospective or cross-sectional studies including relevant data such as relative infant dose, milk-to-plasma ratio, infant drug plasma levels, and adverse events were identified...
June 2016: Bipolar Disorders
Frank J E Vajda, Terrence J O'Brien, Cecilie M Lander, Janet Graham, Mervyn J Eadie
OBJECTIVE: To investigate the relationship between antiepileptic drug (AED) polytherapy in pregnant women and the risk of fetal malformations as prescribing practice changed, with valproate being used less often and at lower doses. Specifically, the risks associated with two of the most common AEDs included in polytherapy over recent years, levetiracetam and topiramate, were examined. METHODS: An observational cohort study in which malformation rates were analyzed in 1,461 pregnancies exposed to AED monotherapy, and in 484 exposed to antiepileptic drug combinations, from the Australian Register of Antiepileptic Drugs in Pregnancy over a 15-year period (1999-2014)...
July 2016: Epilepsia
Andrew G Herzog, Hannah B Mandle, Kaitlyn E Cahill, Kristen M Fowler, W Allen Hauser
PURPOSE: The aim of this study was to determine whether categories of contraception differ in their impact on seizures in women with epilepsy and whether the impact varies by antiepileptic drug category. METHODS: Retrospective survey data came from 2712 contraceptive experiences reported by 1144 women with epilepsy. We compared risk ratios for reports of increase and decrease in seizure frequency on hormonal versus nonhormonal contraception, stratified by antiepileptic drug categories...
July 2016: Epilepsy & Behavior: E&B
Lin Zhang, Hua Li, Shaoping Li, Xiaoyi Zou
OBJECTIVE: We aimed to evaluate the relationship between valproate (VPA) and reproductive endocrine abnormalities in women with bipolar disorder. METHODS: We searched studies in electronic databases of China Biology Medicine disc, PubMed, and Embase. Two authors collected articles and extracted data independently. Meta-analysis was performed for polycystic ovary syndrome (PCOS) and its components. The mean difference (MD) and 95% confidence interval (CI) were used to compare continuous variables...
July 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Richard Balon, Michelle Riba
Prescribing medications during pregnancy can be complicated by a serious negative outcome-harm to the fetus. Probably the 2 best-known examples of medications that can cause severe teratogenicity are thalidomide and isotretinoin. Thalidomide, used for anxiety, insomnia, and tension, was associated with phocomelia (malformation of limbs that many children did not survive).
April 2016: Journal of Clinical Psychiatry
Martin J Brodie
Juvenile myoclonic epilepsy (JME) is a common genetic epilepsy syndrome usually presenting in adolescence and characterized by myoclonic jerks, predominately in the arms, associated with tonic-clonic seizures and less often generalized absences. Although the evidence base for treating JME is weak, most experts regard sodium valproate as drug of first choice. The recent diktat from the European regulatory agency - recommending that sodium valproate should not be prescribed to female children, adolescents or women of childbearing potential unless other treatments were ineffective or not tolerated - has substantially changed the way JME is being managed in this population...
June 2016: Expert Review of Neurotherapeutics
Mar Carreño, Santiago Fernández
Sleep has a strong influence on interictal epileptiform discharges and on epileptic seizures. Interictal epileptiform discharges are activated by sleep deprivation and sleep, and some epilepsies occur almost exclusively during sleep. Treatment of sleep-related epilepsy should take in account the type of epileptic syndrome, the type of seizures, the patient characteristics, and also the pharmacokinetics of the drug. Proper characterization of the epilepsy is essential to choose appropriate antiepileptic drugs...
May 2016: Current Treatment Options in Neurology
Irene Petersen, Rachel L McCrea, Cormac J Sammon, David P J Osborn, Stephen J Evans, Phillip J Cowen, Nick Freemantle, Irwin Nazareth
BACKGROUND: Although many women treated with psychotropic medication become pregnant, no psychotropic medication has been licensed for use in pregnancy. This leaves women and their health-care professionals in a treatment dilemma, as they need to balance the health of the woman with that of the unborn child. The aim of this project was to investigate the risks and benefits of psychotropic medication in women treated for psychosis who become pregnant. OBJECTIVE(S): (1) To provide a descriptive account of psychotropic medication prescribed before pregnancy, during pregnancy and up to 15 months after delivery in UK primary care from 1995 to 2012; (2) to identify risk factors predictive of discontinuation and restarting of lithium (multiple manufacturers), anticonvulsant mood stabilisers and antipsychotic medication; (3) to examine the extent to which pregnancy is a determinant for discontinuation of psychotropic medication; (4) to examine prevalence of records suggestive of adverse mental health, deterioration or relapse 18 months before and during pregnancy, and up to 15 months after delivery; and (5) to estimate absolute and relative risks of adverse maternal and child outcomes of psychotropic treatment in pregnancy...
March 2016: Health Technology Assessment: HTA
Mona Ghadiri-Sani, Nicholas Silver
INTRODUCTION: Chronic tension-type headache (CTTH) is a disorder that evolves from episodic tension-type headache, with daily, or very frequent, episodes of headache lasting hours or they may be continuous. It affects up to 4% of the general population, and is more prevalent in women (up to 65% of cases). METHODS AND OUTCOMES: We conducted a systematic overview, aiming to answer the following clinical questions: What are the effects of drug treatments for CTTH? What are the effects of non-drug treatments for CTTH? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2013 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview)...
2016: Clinical Evidence
Alina Karanti, Mathias Kardell, Ulrika Lundberg, Mikael Landén
BACKGROUND: Lithium is a first line treatment option in bipolar disorder, but several alternative treatments have been introduced in recent years, such as antiepileptic and atypical antipsychotic drugs. Little is known about how this has changed the prescription patterns. We investigated possible changes in the use of mood stabilizers and antidepressants in Sweden during 2007-2013. METHODS: Data was collected from Swedish registers: the National Quality Assurance Register for bipolar disorder (BipoläR), the Prescribed Drug Register, and the Patient Register...
May 2016: Journal of Affective Disorders
Elizabeth E Gerard, Kimford J Meador
PURPOSE OF REVIEW: Caring for a woman with epilepsy requires familiarity with the implications of antiepileptic drugs (AEDs) for pregnancy and contraception as well as an understanding of the effects of female hormones on epilepsy. RECENT FINDINGS: AED pregnancy registries and prospective studies of cognitive development continue to confirm that valproate poses a significantly increased risk of structural and cognitive teratogenesis. In contrast, data thus far suggest that lamotrigine and levetiracetam are associated with a relatively low risk for both anatomic and developmental adverse effects, although further studies are needed for these and other AEDs...
February 2016: Continuum: Lifelong Learning in Neurology
Uma Deshmukh, Jane Adams, Eric A Macklin, Ruby Dhillon, Katherine D McCarthy, Barbara Dworetzky, Autumn Klein, Lewis B Holmes
OBJECTIVES: To evaluate adaptive behavior outcomes of children prenatally exposed to lamotrigine, valproate, or carbamazepine, and to determine if these outcomes were dose-dependent. METHODS: Data were collected from women enrolled in the North American Anti epileptic Drug (AED) Pregnancy Registry who had taken lamotrigine, valproate, or carbamazepine monotherapies throughout pregnancy to suppress seizures. The adaptive behavior of 252 exposed children (including 104 lamotrigine-exposed, 97 carbamazepine-exposed, and 51 valproate-exposed), ages 3- to 6-years-old, was measured using the Vineland-II Adaptive Behavior Scales, administered to each mother by telephone...
March 2016: Neurotoxicology and Teratology
Christina L Wichman
The management of psychiatric disorders during the perinatal period can be difficult; psychiatric decompensation during pregnancy can affect not only the mother but also the fetus and neonate. It is imperative that psychiatric providers proactively discuss pregnancy planning, and be able to thoughtfully weigh the risks of untreated psychiatric illness and psychotropic medications in pregnancy and breast-feeding. With the exception of valproate and carbamazepine, several mood stabilizers and antipsychotics can be utilized during pregnancy with minimal risk to the fetus and neonate in terms of major malformations; there is a growing body of evidence regarding the risk profile of use of these medications in pregnancy...
January 2016: Current Psychiatry Reports
Naghme Adab, Catrin Tudur Smith, Jacqui Vinten, Paula R Williamson, Janine B Winterbottom, Andrew J McKay, Rebecca Bromley
No abstract text is available yet for this article.
December 17, 2015: Cochrane Database of Systematic Reviews
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