lamictal and pregnancy

[morgan86]

hi, my husband and i are trying to make a little one and its proving more difficult than we thought. mainly because no one (doc, neurologist, parents etc) can agree on whether i should stay on the medication during the pregnancy. i know about the cleft pallet and/or lip side effect that can occur. but i also realize that i may have complications if i have a seizure because im not taking anything. my neurologist told me to just stop taking it because my last EEG looked real good. but of course it did since i was medicated. im starting to think he doesnt know wut hes talkin about. but anyways, for now my husband and i decided to taper off and see how i do as i lower the dosage. can anyone share some information with me about this? and those of u who have children with the cleft pallet if u could go back and re do the pregnancy would u think it was worth the risk to go off the med to avoid the defect? also are there other major defects??? im also curious that im not already pregnant. has anyone out there had difficulty conceiving due to their antiepileptic medications??

[survivor]

Getting pregnant and having a baby is always a dream for a woman. Fortunately i had no problems during my pregnancy. I was on Phynetoin during pregnancy, really dont remember what dose!!! But my baby is all fine. I did not have problem in conceiving. Consult ur doctor and go for it!! Best of luck!!

[Nakamova]

Many women have problem-free pregnancies with zero birth defects while on the newest anti-epileptic drugs, including Lamictal. More than 90 percent of pregnant women who have epilepsy deliver healthy babies. In the general population there's about a 3 percent chance for birth defects; in women with epilepsy the chances are about 6 percent. A recent study of Lamictal found that in monotherapy the rate was about 3%, similar to that for the general population. The odds are on your side, especially if your Lamictal dose is relatively low.

One of the best ways to protect the fetus is to be taking a folic acid supplement now while you are trying to conceive, and to also make sure to be taking it during the first trimester. As to whether to stay medicated or to risk having a seizure during your pregnancy -- that's a tough call that should be made in consultation with your neurologist and your OB/GYN, and I suppose it's even tougher if they won't all get on the same page. One potential issue with Lamictal is the way it interacts with estrogen. The blood serum levels can fluctuate significantly, so the dosag needs to be checked often and adjusted several times during pregnancy. Another consideration is breastfeeding -- it's not recommended that you breastfeed while on Lamictal, so there might be some advantage to tapering off the med now, if at all possible.

There's some great info here that you may find helpful in making your decision: http://www.epilepsyfoundation.org/li...lyplanning.cfm

And here's and earlier thread from the archives:
Pregnancy, Epilepsy, and Lamictal

As for problems conceiving, research suggests that women with epilepsy may be more likely to have menstrual irregularities, polycystic ovarian disease and reproductive endocrine disorders -- any of which can reduce fertility. If you don't have any those issues, then you may just need to be patient Best of luck to you and your husband!

[morgan86]

interesting!! thinking going to try and taper down to as low of a dosage i can handle. my neurologist shouldnt have a problem (since he told me to just stop taking it) then maybe if i can handle it i'll try going completely off so i can breast feed. i kind of know already that i'd like to breast feed. just a personal preference. so anyone out there currently pregnant and on lamictal???? OR maybe if anyone out there has a child whos had cleft pallet surgery mind giving me their opinion??

[Wobblez]

I'm watching this thread with interest as I started lamactil 8 weeks ago and I have just hit the 100mg daily dose. I am not trying for a baby but maybe in 18months time I will be ready.

Morgan86, has your neurologist said how damaging, if at all your uncontrolled seizures could be to the foetus? Goodluck with everything, keep us posted =)

[Eibhlin]

I’m really glad you started this thread. I saw the older thread and I had been toying with the idea of starting a new one. I'm a bit of an emotional wreck today so the timing is good. We have been TTC (officially!) for over 3 yrs. I was on 200mg Lamictal for years and have reduced v slowly down to 25mg now (see new-reducing lamictal in the foyer). I’ve been on 5mg folic acid for about 6 yrs.

My neurologist switched me from epilim to lamictal as he said it’s a safer drug. He also said that in all the patients he has, none of them had children with cleft palate. I don’t know if the study controlled for other factors (s.a. genetics), and I think the sample size was quite small. I found that reassuring, but he said it would still be good to try reducing since my seizures have been under control.

Although I was concerned about seizures as a result of changes in hormones during pregnancy, I also would like to breastfeed and felt that now is the time to reduce since I don’t have children yet (still waiting for them to have me!), so I don’t have the challenges of sleep deprivation etc.

For me, the cleft palate isn’t an enormous concern, I know people with cleft palate and I felt and hoped that good nutrition would probably neutralise effects of lamictal.

*I was concerned at the higher dose, and that's why the subject of reducing came up in the first place, but I wasn't afraid of getting pregnant because of what the neurologist said about folic acid. I also hoped that the risk would reduce with a lower dose. For me, it's alot less of a concern now. It's a balancing act.

I wish you success and lots of baby dust

[morgan86]

Eibhlin, are you with child now? what does TTC mean?

[Nakamova]

TTC = Trying To Conceive.

[epileric]

TTC = Trying To Conceive.

Thanks Nak, I didn't think she meant the Toronto Transit Commission.

[morgan86]

well i feel dim lol guess im TTC as well

[epileric]

well i feel dim lol guess im TTC as well

No need for you to feel dim, I'm the one who didn't know what (else) TTC stood for. lol

[Eibhlin]

lol re TTC, very refreshing!!

I usen't know what any of those acronyms used to mean either until recently - you should see the fertility forums - they are full of them, and I haven't a clue -TTC is about all I've got!

With child now? I wish!

[morgan86]

how long have u been trying? if i may ask.

[Eibhlin]

Hi Morgan,

We stopped counting time after 3 years as it was only making us feel worse.

What about you?

[KellyD]

I was on 100mg lamictal twice a day when I fell pregnant with my 2nd baby (only diagnosed after having my 1st) I spoke to our paediatrician, my neurologist and the obstetrician before we got pregnant and basically the info they gave me was lamictal is the safest drug to be on during pregnancy. The neurologist said the chance of defects for a woman without medication is 1 in 100, for a woman on lamictal it was 2 in 100. I was considered to be on a low dose of medication so nobody was really concerned. They recommend taking 5mg folate a day when you take lamictal so my over cautious OB made me increase it to 10mg, particularly in the 1st trimester and several months before conceiving if possible. We were fortunate that our pregnacy and baby were all problem free and we have a beautiful healthy son. Best of luck!

[Eibhlin]

Congratulations Kelly, that's fantastic news and v reassuring!

[TamB1]

I am glad to see people are talking about this. I just found out I am pregnant and at the age of forty-one. I had a right temporal lobectomy 5 years ago and my specialist told me it throw my body into perimenopause. My cycle has been completely different so I believed he was right. However, after not getting it for longer than average I thought I was still too young to go into to menopause. My husband and I bought not only one but three pregnancy tests. I took the first one and like fireworks it went positive. The next one was a digital one and it read Pregnant. We have three daughters who all within the next two months have birthdays so they will be 22 years old, 21 years old and 17 years old. I have my first doctor's appointment with my OB-GYN specialist tomorrow. I am on two meds to control my seizures but I also take multivitamins. I recently began taking 800 mcg's of folic acid. I eat very healthy and the only things I drink are water or lemonaide. I believe I am 10 weeks pregnant now.

[Saiyan MT]

Thanks so much for this post. I've been having this on my mind lately and its nice to hear about Lamictal being pretty agreeable with pregnancy. It gives me a lot of hope and makes me less afraid of my medication.

Good luck to all those TTC and expecting!

[Eibhlin]

TamB1, that's brilliant news - congratulations!! How exciting!

Have any of ye tried alternative therapies for fertility?

I changed to the blood type diet in January (well, gradually - took a few months to completely make the switch!) and I also started Naprotechnology. I had about 5 suspected early miscarriages ('suspected' in that i didn't do pregnancy tests, 'about' in that i didn't keep track - I just thought they were excruciating periods) - the doctors reckoned it must have been as I had quite late periods, contractions (although I've had painful periods, I never had contractions), and when I described what happened, doctors told me that's what it might have been. It was a relief in a way to find out, as in I was getting pg (so things were working somehow!) but it wasn't sticking. Turns out I've low progesterone - which explains it all! I honestly had no idea progesterone was so important.

I heard that Lamictal can affect hormones so it's all making sense now. I'm delighted though to hear success stories, bring them on!! I agree with Saiyan, it also gives me hope!

xxx

[morgan86]

dont know if anyone is still paying attention to this feed but i just thought i'd update real quick. still not pregnant but im off all my meds now. since its been a while im going to schedule an appointment with my doc to check my fertility and my husbands sperm count or however that all works.