lamotrigine, epilepsy drugs and birth defects

[Bernard]

Pregnancy for women with epilepsy can be difficult because the drugs they must take to control their seizures have been associated with a three-fold risk for birth defects.

The newer drug, lamotrigine, introduced in the last decade, appears to reduce the risk for birth defects to 2.9 percent, which is similar to the 2-to-3 percent risk for the general population, the study reported.

...

What's more, 22 percent of the children whose mothers had taken valproic acid while pregnant had IQ scores in the extremely low -- or mentally impaired -- range. In the general population, only 2 percent to 3 percent of children would be likely to fall into this category, said the researchers, from the University Department of Neurosciences in the Walton Centre of Neurology and Neurosurgery in Liverpool, England.

Newer Epilepsy Drug Cuts Risk of Birth Defects - Forbes.com

[Salsa]

I took Dilantin and Tegretol with my pregnancies. My youngest daughter is dx'd with "Fetal Hydantoin Syndrome." With her, this amounts to profound mental retardation and autism. She's also dx'd with ADHD.

Wish I'd been on a different med when pregnant with her, but......well, hindsite.

Here's a page I have for her: http://www.geocities.com/enchantedfo...9044/elizabeth

[lindy]

I was on Dilantin and phenobarbital when I had my second child and was really lucky that she wasn't harmed. Before I became pregnant with her, I asked my ob and my neurologist about birth defects from the drugs and they said that there were none. Wrote to Parke-Davis (doesn't that drug company name date me?) and asked them too. They told me that there were no problems at all. My daughter was born developmentally delayed (speech/language and gross motor skills). She didn't walk or talk until she was almost 2 1/2 but, once she outgrew the drugs or the drugs finally wore out of her system (never knew which), she really took off. When she was 2, Parke-Davis lost a $6 million lawsuit to a couple whose child was born without eyeballs due to Dilantin. Turned out that Parke-Davis had known of the dangers all along and had just kept the information to themselves. After I finished kissing my daughter's beautiful eyes, I called the ob/gyn and had myself sterilized two weeks later.

[Bernard]

Hi Salsa, welcome to the forums. Elizabeth is adorable. I enjoyed your analogy with the trip to Holland.

Birth defects may be the most devastating side effect from drugs that I can think of. It's good that information is much more accessible these days.

[Elisa]

I count myself very lucky that I have two very healthly children. My son I was on Dilantin, and very large amounts by the end of the pregnancy. ( I was siezuring two to three times a day by my third trimester) He believe it or not it "gifted" , a straight A student. My daughter was a "surprise", and I was on Dilantin and Felbatol. At the time they new nothing about Felbatol and pregnancy, and I was told to abort. I tried to do it 3 times, just couldn't do it. I took my chances, I knew that I would love her no matter what. She turned out just fine, @ 9lbs 1oz, she does stuggle in school, and I never know if that has to do with the meds or not.
I count my lucky stars every day.
Elisa

[lindy]

That's interesting, Elisa. I have two children too. With my first child, I hadn't been diagnosed yet so it was a drug free pregnancy. My son is severely dyslexic with a moderate to severe speech/language learning disorder that he struggled very hard over the years to overcome. My second pregnancy was on Dilantin and phenobarbital with the developmental delays in my daughter that I already spoke of. Like your child, she too is gifted. Although, due to the delays when she was a baby, our school system said that she was severely retarded and probably autistic, once the drugs wore off, she took off like a rocket. Graduated #1 in her high school class of 250. 1600 SATs. Graduated summa cum laude, Phi Beta Kapp, from an Ivy League college. Good thing that I didn't believe it when they said that she was retarded!

[Stacy]

Dear Lindy and Elisa,

Thanks for posting on the forum. Sorry it's taken so long to reply. I also have two sons. Both of whom are very smart. One is 5 and the other is 19 months. I was on Depakote with one and Zorontin ( I think) with the other. Both boys are a bit hyper at times, but I haven't noticed any severe abnormalities. I'll keep my eyes open though. Thanks for the information.

[Bernard]

Hey Sweetie, you were not taking any meds with the first child. You were 4 years seizure free at that time. You took Zorontin before I met you.

[Julie C]

Hi I was on Tegretol with my first child now 15 and Tegretol Retard with the 3rd child now 11.Hazel aged 15 has Complex Partial Epilepsy,Aspergers,Learning Difficulties,Asthma & possibly ADHD.Zack aged 11 has Aspergers,Learning Difficulties,Asthma,ADD both had speech problems and delayed development in their early years.My 14 year old daughter Kim has Asthma but has no other problems,my 7 year old son Jake has Asthma & Slight Learning Difficulty but is slowly over coming this.Take care luv Juliexx

[Axa]

I admire your courage, girls!

My partner and I decided not to have children. We just didn't want to risk. You can call us selfish but we prefer to have Axa OK than have a child.

My seizures are connected with monthly hormonal changes and we haven't got any strong enough assurance that with the changes during the pregnancy my condition won't get worse. Also, we were afraid that something would be wrong with the child.

Since we haven't had a really strong urge to become a parents we decided against having a child by common consent.

Axa

[lindy]

As much as I hate the deceptiveness of the drug companies when it comes to side effects and the possibility of birth defects, I am glad that I didn't know and went ahead with our second child. However, as soon as my eyes were opened, I did have myself sterilized so I can see why you made this choice, Axa. Besides, if you didn't have a strong urge to become a parent, it's better not to do it. I have a friend who was talking about having a child with his wife because they wanted "the experience". I told him that he was crazy - having a baby is an experience that lasts the rest of your life and isn't something that you can just do and then go on to something else.

[Axa]

If I were without E and especially without anti-epileptic drug therapy, we would decide for a kid. But when we were browsing through the different epilepsy forums, we got an impression that there were just a little to many moms with E who have children with this or that difficulty & illness.

Since we were a little bit scared and wanted some more reassurance from ob/gyn and neurologist then we really got, we just didn't want to risk.

Because all those years it was me who took care about contraception my OH decided to take his part and went to vasectomy. (For all of you who are thinking about some "definite" sort of contraception: he says it's really nothing to be scared!) I think this was really nice gesture on his part.

Best

Axa

[Bernard]

Looks like Lamictal / Lamotrigine interferes with the pill (oral contraceptive):

Drug maker GlaxoSmithKline has issued a "Dear Doctor" letter advising that its anti-epilepsy drug Lamictal (lamotrigine) can reduce the effectiveness of oral contraceptives.

New data have demonstrated an interaction between combined oral contraceptives and lamotrigine which could lead to reduced effectiveness of hormonal contraceptives, a revised product label states.

Lamictal cuts effectiveness of the pill

[Bernard]

Looks like Lamotrigine/Lamictal may not be as safe as originally touted:

New information suggests that babies exposed to Lamictal during the first three months of pregnancy may have a higher chance of being born with a cleft lip or cleft palate.

Lamotrigine - FDA