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Second-Generation Antiepileptic Drugs and Pregnancy: A Guide For Clinicians.

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Second-Generation Antiepileptic Drugs and Pregnancy: A Guide For Clinicians.

Post  Admin on Tue Jun 05, 2012 10:58 pm

Second-Generation Antiepileptic Drugs and Pregnancy: A Guide For Clinicians.
Expert Rev Neurother. 2012 Jun;12(6):707-17.



When treating pregnant women with antiepileptic drugs (AEDs), clinicians have to balance potential fetal adverse effects against the risks of uncontrolled maternal disease. Only recently have emerging scientic data provided a rational basis for treatment decisions considering both aspects. The focus of research is currently moving from the first to the second AED generation.
Lamotrigine is relatively well studied, and data on other novel AEDs, such as levetiracetam, oxcarbazepine, topiramate, zonisamide, gabapentin and pregabalin, are in progress. Safety issues appear to be favorable for lamotrigine, and preliminary results are also promising for levetiracetam and oxcarbazepine.
Drugs metabolized by uridine-diphospate glucuronosyl transferase or excreted unchanged by the kidneys are particularly susceptible to increased body clearance during pregnancy. Lamotrigine is subject to both mechanisms, and therapeutic serum levels may sometimes be difficult to maintain.

The authors review the recommendations and clinical research on modern AED treatment during pregnancy, highlighting current experience with second-generation drugs. Read the complete article here: http://www.expert-reviews.com/doi/pdf/10.1586/ern.12.32

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