Pregnancy and Lamictal medication

Lamictal, also known as Lamotrigine, is a drug that is used in the treatment of Bipolar Disorder as a mood stabilizer and Epilepsy as an anticonvulsant.

When a woman is pregnant, it is imperative that she do what is best for the developing baby. Sometimes it may be less dangerous to take an anticonvulsant medication while pregnant to ensure that the mother to be does not have a seizure during pregnancy and delivery.

Lamictal has been prescribed to pregnant women by their physicians because it is thought that this drug has fewer side effects to the unborn baby than do some of the other commonly used anticonvulsant drugs.

Since Lamictal is a relatively new drug there have not been sufficient controlled studies of Lamictal in pregnant women to determine the medication's risk to the woman and fetus. However, there have been animal studies to suggest that Lamictal may have a potential risk to the developing fetus because it has been shown to deplete the concentration of folic acid, which is a B vitamin, in rats. When there are lower concentrations of folic acid, there will likely be harmful effects to the fetus, the most well known of these is Spina Bifida. For this reason it is important to avoid the use of Lamictal during pregnancy whenever possible, especially during the first trimester of the pregnancy. However, if Lamictal is required because stopping the medication may bring about a greater danger to the mother and unborn child, the pregnant woman may continue taking Lamictal, if she is informed of the risks to her and the fetus. It would be important for the woman to take folic acid daily to replenish the levels in the fetus.

An observational study at the International Pregnancy Registry for the use of Lamictal has been conducted by GlaxoSmithKline, in consultation with the Centers for Disease Control and Prevention (CDC) and other pertinent agencies, to track the effects of Lamictal on pregnancy outcomes when mothers have been exposed to Lamictal at any time during pregnancy. To enable accurate monitoring of the pregnancy, doctors are able to register patients before the birth of the baby, for example, ultrasound, results of other tests such as amniocentesis, and finally the birth.

The North American AED Pregnancy Registry, located at Massachusetts General Hospital in Boston, Massachusetts, found that infants who are exposed to Lamictral during pregnancy have a higher risk of having oral problems, than infants born to women in another group and who were not exposed to the drug during their pregnancies. Oral cleft problems are birth defects that may involve the lip, or the palate, or both. These birth defects occur when the normal openings between the upper lip and the nose (in the cleft lip) or between the roof or back of the mouth and the nose (in the cleft palate) may not close normally. These oral problems can usually be seen in an ultrasound test and can usually be corrected after birth with surgery but the child may be left with some speech difficulties and scars from the surgery.

There have been accounts of relatively trouble-free pregnancies and completely healthy children born to mothers that were expeosed to Lamictal throughout their pregnancies. The common threads that tie these healthy pregnancies and children together is having a neurologist and OBGYN that work closely together, regular monitoring the woman and the fetus regularly. Also, the woman can opt for a cesarean section rather than a vaginal birth. Vaginal birth can cause exhaustion and is very stressful; this can bring on siezures.

It is not recommended to breast feed the baby because Lamictal is transferred to the baby through the breast milk and it is not known if it is safe for the baby.