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https://www.readbyqxmd.com/read/29144993/evaluate-the-effects-of-antiepileptic-drugs-on-reproductive-endocrine-system-in-newly-diagnosed-female-epileptic-patients-receiving-either-valproate-or-lamotrigine-monotherapy-a-prospective-study
#1
Harpreet Singh Sidhu, R Srinivasa, Akshay Sadhotra
OBJECTIVE: To investigate the development of reproductive endocrine changes in Indian women with epilepsy initiating on either Valproate (VPA) or Lamotrigine (LTG) monotherapy. METHODS: Reproductive hormonal profiles, hirsutism, ovarian morphology by ultrasonography and menstrual cycle data in newly diagnosed women with epilepsy taking VPA (n=34) or LTG (n=32) monotherapy were compared. None of the women were receiving hormonal contraception. Patients gave details of seizure type and frequency, medical and drug history...
October 28, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29114815/maternal-use-of-antiepileptic-agents-during-pregnancy-and-major-congenital-malformations-in-children
#2
Rebecca L Bromley, Jennifer Weston, Anthony G Marson
Clinical Question: Is maternal use of antiepileptic drugs during pregnancy associated with major congenital malformations in children? Bottom Line: Certain antiepileptic drugs were associated with increased rates of congenital malformations (eg, spina bifida, cardiac anomalies). Lamotrigine (2.31% in 4195 pregnancies) and levetiracetam (1.77% in 817 pregnancies) were associated with the lowest risk and valproate was associated with the highest risk (10.93% in 2565 pregnancies) compared with the offspring of women without epilepsy (2...
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29073690/fetal-valproate-syndrome-still-a-problem-today
#3
Katharina Wiedemann, Tanja Stüber, Monika Rehn, Eric Frieauff
Introduction Fetal exposition to valproate can lead to a cluster of facial dysmorphism, congenital anomalies and neurodevelopmental retardation. Case Report In this report we describe 2 cases of fetal valproate syndrome. In the first case, the gravida had a valproate medication before and during pregnancy with additional folic acid. She delivered a male premature infant at 25+2 weeks of gestation due to preterm labor and rupture of the membranes. Physical examination showed even in the premature infant typical signs of fetal valproate syndrome with trigonocephaly, epicanthal folds, broad root of the nose, low-set ears, thin upper lip and anteverted nares...
October 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29019422/pharmacotherapy-of-mood-disorders-and-psychosis-in-pre-and-post-natal-women
#4
Beth Smith, Steven L Dubovsky
Untreated mood and psychotic disorders can have substantial adverse impacts on the patient, the fetus and the family, while treatment can ameliorate such problems. To address concerns by clinicians about the risks of psychotropic medications, this review addresses the risk/benefit analysis of somatic therapies for psychiatric disorders during pregnancy and lactation. Areas covered: All available research was reviewed on the impact on pregnancy and breastfeeding of mood and psychotic disorders, and of antidepressants, mood stabilizers, antipsychotic drugs, and electroconvulsive therapy...
November 7, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28953852/prescription-of-sodium-valproate-as-a-mood-stabiliser-in-pregnancy
#5
Kate Womersley
This essay was submitted for the Royal College of Psychiatry's perinatal psychiatry medical student essay prize in 2017. The essay considers the choices available to women with bipolar disorder who become pregnant while taking sodium valproate to treat mania or for mood stabilisation. The implications of three options are considered: to stop all treatment, to switch to a different mood stabiliser or to continue on sodium valproate. The implications for the fetus, on the mother's wellbeing and the ethics of patient choice are discussed...
September 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/28941829/the-clinical-features-and-functional-impact-of-valproate-induced-tremor
#6
Marlene Alonso-Juarez, Diego Torres-Russotto, Paulina Crespo-Morfin, José Fidel Baizabal-Carvallo
BACKGROUND: Tremor is a known side-effect of anticonvulsants, particularly of valproate. However, there is a dearth of information regarding detailed clinical features and functional impact of valproate-induced tremor. METHODS: We studied a cohort of patients treated with anticonvulsants for neurological disorders, through blinded evaluations using the Clinical Rating Scale for Tremor (CRST); we compared the frequency, severity and functional impact of drug-induced tremor between patients treated with valproate and those treated with other anticonvulsants...
September 15, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28939551/women-still-not-being-told-about-pregnancy-risks-of-valproate
#7
Jacqui Wise
No abstract text is available yet for this article.
September 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28836089/risk-factors-for-sodium-valproate-induced-renal-tubular-dysfunction
#8
Satoko Koga, Takahisa Kimata, Sohsaku Yamanouchi, Shoji Tsuji, Ken Yoshimura, Atsushi Araki, Kazunari Kaneko
OBJECTIVE: To explore the risk factors for the development of sodium valproate (VPA)-induced renal tubular dysfunction for early diagnosis and treatment. STUDY DESIGN: The subjects were selected from patients who were diagnosed with epilepsy and administered VPA. Blood and spot urine samples were collected and measured the concentration of VPA, the level of serum phosphorus, serum uric acid, serum free carnitine, serum cystatin-c, and urine β2-microglobulin (BMG)...
August 23, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28833045/pharmacokinetic-variability-of-valproate-in-women-of-childbearing-age
#9
Cecilie Johannessen Landmark, Margrete Larsen Burns, Arton Baftiu, Anette Huuse Farmen, Morten I Lossius, Svein I Johannessen, Torbjörn Tomson
The purpose was to investigate pharmacokinetic variability of valproic acid (VPA) in women of childbearing age by therapeutic drug monitoring (TDM) data to elucidate the variable relationship between dose and serum concentrations with the ultimate aim of facilitating safer use of VPA. Anonymized retrospective data from the TDM database (2006-2015) at the National Center for Epilepsy in Norway were used. Trough total concentrations of VPA at assumed steady state in women aged 14-46 years were analyzed. Data from 643 nonpregnant women of childbearing age (mean age = 27 years) were included...
October 2017: Epilepsia
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
#10
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/28629296/atypical-antipsychotic-use-and-outcomes-in-an-urban-maternal-mental-health-service
#11
Susan Hatters Friedman, Charmian Moller-Olsen, Chandni Prakash, Abigail North
Objective Despite many women suffering from psychosis in their childbearing years, limited data exist about the use of atypical antipsychotic agents in pregnancy. Atypical antipsychotic agents are often used to treat bipolar disorder, instead of lithium or valproate because of the known teratogenicity of those agents. As well, atypical antipsychotics are often prescribed in anxiety disorders and depression. This study sought to describe pregnancy outcomes for women prescribed atypical antipsychotics during pregnancy...
August 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28472982/comparative-safety-of-anti-epileptic-drugs-during-pregnancy-a-systematic-review-and-network-meta-analysis-of-congenital-malformations-and-prenatal-outcomes
#12
COMPARATIVE STUDY
Areti Angeliki Veroniki, Elise Cogo, Patricia Rios, 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
BACKGROUND: Pregnant women with epilepsy frequently experience seizures related to pregnancy complications and are often prescribed anti-epileptic drugs (AEDs) to manage their symptoms. However, less is known about the comparative safety of AED exposure in utero. We aimed to compare the risk of congenital malformations (CMs) and prenatal outcomes of AEDs in infants/children who were exposed to AEDs in utero through a systematic review and Bayesian random-effects network meta-analysis...
May 5, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28412607/effect-of-early-postnatal-exposure-to-valproate-on-neurobehavioral-development-and-regional-bdnf-expression-in-two-strains-of-mice
#13
Kevin G Bath, Tiare Pimentel
Valproate has been used for over 30years as a first-line treatment for epilepsy. In recent years, prenatal exposure to valproate has been associated with teratogenic effects, limiting its use in women that are pregnant or of childbearing age. However, despite its potential detrimental effects on development, valproate continues to be prescribed at high rates in pediatric populations in some countries. Animal models allow us to test hypotheses regarding the potential effects of postnatal valproate exposure on neurobehavioral development, as well as identify potential mechanisms mediating observed effects...
May 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28365440/evaluate-the-effects-of-long-term-valproic-acid-treatment-on-metabolic-profiles-in-newly-diagnosed-or-untreated-female-epileptic-patients-a-prospective-study
#14
Harpreet Singh Sidhu, R Srinivas, Akshay Sadhotra
PURPOSE: Excessive weight gain associated with sodium valproate (VPA) may predispose patients with epilepsy to other health problems such as insulin resistance. We prospectively evaluated the long-term impact of VPA monotherapy compared with lamotrigine (LTG) monotherapy on anthropometric and metabolic parameters in women with epilepsy. Our primary objective is to understand the underlying mechanism responsible for VPA-induced obesity. METHODS: Sixty-six female patients with newly diagnosed or untreated epilepsy were included in the study...
March 22, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28342959/early-lance-adams-syndrome-after-cardiac-arrest-prevalence-time-to-return-to-awareness-and-outcome-in-a-large-cohort
#15
Irene Aicua Rapun, Jan Novy, Daria Solari, Mauro Oddo, Andrea O Rossetti
INTRODUCTION: Early myoclonus after cardiac arrest (CA) is traditionally viewed as a poor prognostic sign (status myoclonus). However, some patients may present early Lance-Adams syndrome (LAS): under appropriate treatment, they can reach a satisfactory functional outcome. Our aim was to describe their profile, focusing on pharmacologic management in the ICU, time to return of awareness, and long-term prognosis. METHODS: Adults with early LAS (defined as generalized myoclonus within 96h, with epileptiform EEG within 48h after CA) were retrospectively identified in our CA registry between 2006 and 2016...
June 2017: Resuscitation
https://www.readbyqxmd.com/read/28243149/antiepileptic-drugs-prescribed-in-pregnancy-and-prevalence-of-major-congenital-malformations-comparative-prevalence-studies
#16
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/28237319/epilepsy-treatment-in-adults-and-adolescents-expert-opinion-2016
#17
REVIEW
Jerry J Shih, Julia B Whitlock, Nicole Chimato, Emily Vargas, Steven C Karceski, Ryan D Frank
INTRODUCTION: There are over twenty anti-seizure medications and anti-seizure devices available commercially in the United States. The multitude of treatment options for seizures can present a challenge to clinicians, especially those who are not subspecialists in the epilepsy field. Many clinical questions are not adequately answered in double-blind randomized controlled studies. In the presence of a knowledge gap, many clinicians consult a respected colleague with acknowledged expertise in the field...
April 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28212902/intrauterine-valproate-exposure-is-associated-with-alterations-in-hippocampal-cell-numbers-and-folate-metabolism-in-a-rat-model-of-valproate-teratogenicity
#18
Alexander Semmler, Christian Frisch, Christiane Bleul, Desiree Smith, Laurent Bigler, Jean-Christophe Prost, Henk Blom, Michael Linnebank
PURPOSE: Valproate is one of the most commonly used anticonvulsive drugs. Despite its significant benefits, the teratogenicity of valproate is a relevant problem in the treatment of women of childbearing age. In addition to major congenital malformations, such as neural tube defects, reduced intelligence and attention after intrauterine valproate exposure are reported. Until now the mechanisms of teratogenicity of VPA are poorly understood and concepts how to reduce valproate teratogenicity are lacking...
March 2017: Seizure: the Journal of the British Epilepsy Association
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/28061833/combining-adverse-pregnancy-and-perinatal-outcomes-for-women-exposed-to-antiepileptic-drugs-during-pregnancy-using-a-latent-trait-model
#20
Xuerong Wen, Abraham Hartzema, Joseph A Delaney, Babette Brumback, Xuefeng Liu, Robert Egerman, Jeffrey Roth, Rich Segal, Kimford J Meador
BACKGROUND: Application of latent variable models in medical research are becoming increasingly popular. A latent trait model is developed to combine rare birth defect outcomes in an index of infant morbidity. METHODS: This study employed four statewide, retrospective 10-year data sources (1999 to 2009). The study cohort consisted of all female Florida Medicaid enrollees who delivered a live singleton infant during study period. Drug exposure was defined as any exposure to Antiepileptic drugs (AEDs) during pregnancy...
January 6, 2017: BMC Pregnancy and Childbirth
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