Epilepsy Drug Side Effect May Increase Pregnancy Risks: Study

Women who take epilepsy drugs like Depakote and Tegretol, may be more likely to experience pregnancy complications than women with and without epilepsy who do not take anti-seizure drugs, according to the findings of a new study.  

For years, women with epilepsy have been told that epileptic seizures were dangerous to their unborn child and the welfare of their pregnancy, however Norwegian researchers say that their findings, which were published in the current issue of BJOG: An International Journal of Obstetrics & Gynaecology, may indicate that women who take epilepsy drugs have more problems during pregnancy than those that do not.

Much attention has been focused lately on birth defects from epilepsy drugs, and this study again found a much higher rate of malformations among women who took the medications during pregnancy. However, the researchers also found that women taking epilepsy drugs were also at increased risk of pre-eclampsia (pregnancy-induced hypertension and protein buildup), which can be fatal, as well as vaginal bleeding, postpartum hemorrhage, and increased risks of delivery complications that required vaginal operative deliveries or caesarean section deliveries.

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The researchers, from the University of Bergen, determined that the increased risks appeared to be mainly associated to the use of epilepsy drugs and were not due to seizures, obesity, lack of folate or unusually high doses of antiepileptics.

The study looked at more than 400 women who delivered babies in Bergen, Norway between 1999 and 2006, half of whom had epilepsy and half who did not. Researchers found that 8 percent of women taking antiseizure drugs were diagnosed with pre-eclampsia during pregnancy, which can kill both mother and child. That compares to only 3% among women who do not take the drugs, whether they had epilepsy or not.

The researchers also found that women taking the drugs had double the risk of requiring induced labor and emergency Cesarean sections and were 6.5 times as likely to have a child with birth defects.

The study comes amid growing concerns about side effects of epilepsy drugs on unborn children, particularly involving use of Depakote, Tegretol and Topamax.

Depakote was approved in the United States in 1978 for treatment of certain forms of epilepsy. However, Depakote pregnancy side effects have been linked to an increased risk of severe birth defects when taken during the first trimester, especially during the first 28 days when neural tube closure and other critical formations are taking place.

In 2006, the FDA added a “black box” warning about the potential risk of Depakote birth defects after a study found that 20% of pregnant mothers who gave birth while on Depakote had a child with malformations or a birth defect. Birth defects associated with Depakote include spina bifida, cleft palate, abnormal skull development, malformed limbs, holes in the heart and urinary tract problems.

In recent months, a growing number of Depakote lawsuits have been filed against Abbott Laboratories by families of children born with spina bifida and other birth defects or malformations.

Similar pregnancy side effects have been identified with carbamazepine, which is marketed as Tegretol, Carbatrol, Epitol and Equetrol. According to a study last year, 3.3% of women who took the drug during the first trimester gave birth to children with malformations or defects. The Tegretol birth defect side effects were assoicated with a 2.6 times higher risk of having a child born with spina bifida than women who were not exposed to carbamazepine.

Topamax (topiramate), which is a newer epilepsy drug approved in 2004, has also been associated with a risk of problems when used during pregnancy.

On March 4, the FDA announced that new warnings about the risk of oral clefts from Topamax would be added to the medication’s label after data showed infants exposed to Topamax during the first trimester of pregnancy, when many women do not even know they are pregnant, face an increased risk of cleft lip or cleft palate.

A number of women who have given birth to children with a defect or malformation after using the drug while pregnant are considering a potential Topamax lawsuit against the drug makers as a result of their failure to research the pregnancy risks associated with the medication or adequately warn about the risk of Topamax cleft palate and lip problems.

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5 Comments

  • KristenJanuary 22, 2013 at 8:32 pm

    I to was on Tegretol at the time of pregnancy. I planned my pregnancy and went to my Neuro at a very highly acclaimed University and he said it was safe as well. Even got out medical books and another doctor to talk to me about the only risk being a cleft palate, if that, cause it was a small precentage. Turned out I was on bedrest after a few months, high blood pressure and delivered with problem[Show More]I to was on Tegretol at the time of pregnancy. I planned my pregnancy and went to my Neuro at a very highly acclaimed University and he said it was safe as well. Even got out medical books and another doctor to talk to me about the only risk being a cleft palate, if that, cause it was a small precentage. Turned out I was on bedrest after a few months, high blood pressure and delivered with problems a month early. He has breathing right from day 1, and now I am a single mother raising a child with Autism, ADHD, anietxy disorders, behavior problems, sensoryissues and still goes o speech and occupational therepy weekly. He doesnt understand pain, danger, he is bullied constantly and has a weakend immune system due to his severe asthma, allergies, chest pains, gastrological illnesses etc. List goes on he currently goes to about 8 specialist. The only child in the family like this. I tried to have another child soon after but sadly lost that one. The dotors lied to me and now it was a catgory D when I got pregnant. It was the best new thing youcould take. Idont see anyone else taking care of my son. Worse thing of all I think about is what will happen to him if something happens to me.

  • JenniferJanuary 4, 2013 at 1:49 am

    Back in 1996 I became pregnant while i was on tegertol & depakote. I was told back then that it was safe. But, when I had my baby he was born with multiple birth defects. He was never diagnosed with anything specific except hypotonic. Unfortunately, he only lived a few months. I asked about the meds and was brushed off... Now, it seems like every birth defect he had is showing up with these me[Show More]Back in 1996 I became pregnant while i was on tegertol & depakote. I was told back then that it was safe. But, when I had my baby he was born with multiple birth defects. He was never diagnosed with anything specific except hypotonic. Unfortunately, he only lived a few months. I asked about the meds and was brushed off... Now, it seems like every birth defect he had is showing up with these medications. :(

  • JoanneJune 18, 2012 at 3:40 pm

    I was put on to tegretol in 2007 as I approached my neurologist that we would like to have a new addition to the family and he gave me those saying they were the safest to take sadly this wasn't the case my waters broke at 28 weeks and managed to carry on till 33 weeks he was born at 4lb 7oz. When my son was 8 weeks old that's when we noticed the difference his head circumference went off the char[Show More]I was put on to tegretol in 2007 as I approached my neurologist that we would like to have a new addition to the family and he gave me those saying they were the safest to take sadly this wasn't the case my waters broke at 28 weeks and managed to carry on till 33 weeks he was born at 4lb 7oz. When my son was 8 weeks old that's when we noticed the difference his head circumference went off the chart so an MRI got performed which showed Cerebral Atrophy ( loss of brain cells) his development was delayed and has since been diagnosed as severly autistic he can't feed,clothe or communicate with anyone and he will be 4 next month I had to give up work to care for him which can be immensly stressful as he don't have any sense of danger or understanding of his surroundings and can get into some potentially dangerous situations if not watched constantly I regret taking tegretol I did on the advise of the doctor recommending it was the safest but my son has yet been diagnosed the reason at to what caused the cerebral atrophy even after lengthy tests genetic metabolic and biochemical testing my new neuro after hearing all this said " well if all that testing has been done and the other doctors still haven't come up with anything then yes it was possibly the medication that caused it"

  • JamieJune 16, 2011 at 1:56 pm

    My doctor prescribed Keppra XR for me, and I have been on that since 2009. While pregnant in 2006, I was on Trileptal.

  • AngelinaJune 15, 2011 at 6:02 pm

    What should be used by the women instead of antiseizure drugs. As it is written in the prescription given by the dr.

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