Lamotrigine- Newly prescribed, worries about pregnancy

[Funny_Hat_UK]

Hello everyone.

I'm writing on behalf of my sister, Laura; she is 25 and had her third seizure this morning. (She is okay; a bit bruised as it was on the pavement but thankfully her boyfriend was with her. She's sleeping it off).

Her last two fits have been in the past two months (her first was back in Feb '09) and was prescribed Lamotrigine after her second fit, but wasn't filled with confidence by the specialist who handed them over, so she decided to do some research online. She read a medical journal which described Lamotrigine to have side effects on newborn babies such as cleft lips and even spina bifida.

Now, even though she and her boyfriend are not planning to have a baby just yet, she is still hesitant to start the course of pills. Aside from the baby effects, she is also not keen on lifelong medication. But since this morning's seizure which was milliseconds before she was about to cross the road, I think she's coming to realise that she needs to think of her welfare in the present before she thinks about her concerns for plans in the future.

Copied and pasted from 'NetDoctor.co.uk':
Lamotrigine - Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

It is vital that women with epilepsy receive specialist advice before getting pregnant, so they are well informed of potential risks and benefits of continuing antiepileptic treatment during pregnancy. Pregnant women taking antiepileptic medicine have a higher risk of carrying a baby with developmental problems and malformations. However, if a woman with epilepsy stops treatment because she is pregnant, there is a risk of seizures that can harm both mother and baby.

If you decide to try for a baby while taking lamotrigine you should seek medical advice from your doctor as soon as possible. It may be recommended that you start taking folic acid 5mg daily as soon as contraception is stopped, as this may reduce the risk of neural tube defects such as spina bifida in the baby.

Women who continue to take lamotrigine during a pregnancy should, wherever possible, be prescribed lamotrigine on its own, in the lowest effective dose. Your doctor may need to adjust your lamotrigine dose from time to time, because changes to your body during pregnancy may affect the amount of lamotrigine in your blood and its effectiveness.

Lamotrigine passes into breast milk. Mothers who need to take lamotrigine should discuss the pros and cons of breastfeeding with their doctor. You should only breastfeed if the potential benefits of breastfeeding are considered to be greater than the risk of side effects from the medicine on the nursing infant. Seek medical advice from your doctor.

Is there anyone on this Forum that perhaps shared similar worries with this particular drug? I want to give her as much assurance as possible that this is the right thing to do. My boyfriend's auntie died on this day four years ago when she stopped taking her meds for a period of time, then had a fit and fatally banged her head. (Creepy coincidence, huh?)

It feels a bit like she's pushing her luck- with all three seizures, she has been lucky to have her boyfriend with her, but what if the next ones are when she's alone, out of her comfort zones, somewhere dangerous? I dread to think.

I'm going to include the dancing banana here now because it makes me smile.

Thanks a bunch in advance to anyone who took the time to read this and reply!

Amanda x

[Nakamova]

Hi Amanda, welcome to CWE!

Good for you for helping out your sister with this. Lamictal is considered one of the safer drugs for pregnancy, and the vast majority (90%) of babies born to moms on anti-epileptic drugs are healthy. The main thing is to make sure her neurologist and OB-GYN are on the same page.

It's very important that your sister takes a folic acid supplelement now and especially in the early months of a pregnancy -- that can help protect against birth defects. Lamictal blood levels can vary as estrogen levels change during the pregnancy, so your sister may need to have her levels tested at several times throughout, and have her dose adjusted accordingly.

Here are some threads from the CWE archives that may be helpful to you and your sister:
If you're thinking of getting pregnant...
lamotrigine, epilepsy drugs and birth defects
http://www.coping-with-epilepsy.com/...y-advice-6243/
Yet another pregnancy question

Best,
Nakamova

[Funny_Hat_UK]

Hi Amanda, welcome to CWE!

Good for you for helping out your sister with this. Lamictal is considered one of the safer drugs for pregnancy, and the vast majority (90%) of babies born to moms on anti-epileptic drugs are healthy. The main thing is to make sure her neurologist and OB-GYN are on the same page.

It's very important that your sister takes a folic acid supplelement now and especially in the early months of a pregnancy -- that can help protect against birth defects. Lamictal blood levels can vary as estrogen levels change during the pregnancy, so your sister may need to have her levels tested at several times throughout, and have her dose adjusted accordingly.

Here are some threads from the CWE archives that may be helpful to you and your sister:

* URL links removed due to newbie restrictions *

Best,
Nakamova

Hi Nakamova!

Thanks for taking the time to read my thread and post a reply

The links to previous threads are GREAT, thanks a bunch! I haven't had the chance to attend any of her GP or specialist appointments yet, so it's very informative for me as well! I will be sharing the log in details to this account with my sister once she's feeling a bit more with-it. That way, if she has any questions, she can come to the Forum and ask people who can give honest and personal answers.

I just had to Google 'Lamictal'- I didn't realise it had a different marketing name in the U.S from the English 'Lamotrigine'.

Again, thank you!

Amanda

[Nakamova]

Sorry about that, I'm so used to using Lamictal and Lamotrigine interchangeably. "Lamictal" is the brand name version, while "Lamotrigine" is the generic (cheaper) version.