Pregnancy, Epilepsy, and Lamictal

[BRIROB]

Is anyone familiar with an epileptic pregnant mother on lamictal? My 17year old daughter is 13 weeks pregnant, has a non specified form of generalized clonic tonic seizures, and is on 150mg 2x's per day of Lamictal. She continues to have seizures during her pregnancy even on the Lamictal. Certainly not as often as when she wasn't on it but they are still pretty prevalent. She had 3 in two days last week and one this week each lasting about 4 minutes. Her pediatric neurologist won;t see her anymore because she's pregnant. He says she needs to see an adult neurologist and possibly a genetic specialist, I'm concerned about the baby for a number of reasons. (1) The lack of oxygen during the seizures and (2) the affect the Lamictal may have on the baby. The OBGYN doesn't seam to have an answer on this other than that it's better for her to be on the medicine than not. She said the medication will have less of an effect on the baby than the lack of oxygen. But what about both. The pediatric neurologist said the Lamictal should have little affect on the baby other than the seizures will probably be passed on to the baby and the Lamictal could possibly cause a cleft lip or pallet on the baby. Does anyone else have any experience with this? --Thanks, Bridgetonder:Any other experience anyone might be able to share?

 

[Nakamova]

Hi Bridget --

There are folks here on this site who have had healthy children while on AEDs, so I hope they will chime in soon.

Lamictal is considered one of the safer drugs for pregnancy, but it's tricky because it can also get flushed out of the body at a faster-than-normal rate by high levels of estrogen. So your daughter's Lamictal levels may need to be checked and adjusted upward to prevent additional seizures. She should definitely be seeing a neurologist who can help with this, ideally one who has experience with pregnancy. (It's unfortunate that her pediatric neurologist is being so unhelpful). I'm not sure what role a genetic specialist would play -- epilepsy can hereditary, but that doesn't seem relevant during the pregnancy.

I hope your daughter can get to a more helpful neurologist soon.

Best,
Nakamova

 

[Bella2010]

Hi Bridget,

I am in a similar situation as your daughter. I am almost 6 months pregnant, and I am taking Lamictal. I have had four seizures so far, and I have adjusted my dose to 600 mgs, double my pre-preg dose.

My neuro told me that Lamictal is one of the best meds to be on while pregnant because it has a very low risk of birth defects. He mentioned the possibility of a cleft pallet was 3 to 4 % higher than the general population. It also has a possibility of neural tube defects. So, he advised taking extra folic acid.

The doc said the biggest risk of having seizures while pregnant is falling. He didn't mention the baby being deprived of oxygen, although I see your point with that. Sorry I don't have anymore info on that subject for you.

Anyway, my most recent ultrasound was at 20 weeks, and everything looked good. The doc said that at the time the cleft is totally developed yet, but so far Baby's looked like it was coming together. Spine looked good, too.

My heart goes out to you and your daughter. This is supposed to be a joyful event, and it sucks that it is marred by going through this crap.

Anyway, I hope your daughter finds help soon!

Beth

 

[gigi]

the miracle of life

Hi Bridget:

I am 52 years old and have two grown healthy children whom I took Dilantin with during my pregnancies. I do not bring this subject up as a rule to pregnant women, but this site and subject obviously makes it appropriate. My second child was a full term stillborn baby boy. I had one seizure two weeks before my due date. I will not go into detail, but the medication is the lesser of two evils. Be vigilent about her pregnancy, and do not depend just on the doctors to guide you. Make sure she is looked after. I made the mistake of hanging on the doctors every word with my epilepsy, instead of also relying on my better judgment. My Dilantin with my third pregnancy,was kept at a high dose, as I was obviously a double high risk. My daughter is 21, healthy and just had a healthy baby boy. Enough said. Good luck, and take care of Momma and baby.

Regards,

gigi

 

[dumbspouse]

I don't have any personal experience with lamictal and pregnancy even though my wife is taking it right now. My nephew who is 14 now was born with a cleft lip and palette and is fine and you can barley tell he had it. Cleft lip or palette is a lot more common than you think. Hope all goes well.

 

[skillefer]

I had a baby 7 months ago. I'm on Dilantin now...but my high risk ob wanted me on Lamictal. My piece of advice would be make sure she's taking folic acid. I was taking 800mcg..as well as what was in the prenatal. ANd to take good care of herself..weight, sleep, hidration, etc. Get an OB that has experience w/ women with seizures. They can adjust meds if necessary.

 

[aprilg]

Hi Bridget,
I know you asked this over a month ago, but hopefully my experiences can help and give you hope.

Here are my situations with meds and pregnancy:
Two weeks before my due date I had several recurring grand mal seizures. I was only taking 200 mg dilantin/day and my hormones at the end of the pregnancy depleted my blood of the meds. I had an emergency c-section two weeks before my due date. She was completely healthy and still is at 6 years old.

During my second pregnancy I was taking 400 mg Dilantin/day and had a scheduled c-section two weeks early to avoid the high hormones during the end of pregnancy. She was also fine and healthy. I was even able to nurse both of them for almost a year. She is now 4 and healthy.

During my last pregnancy I was taking 400 mg Dilantin and 800 mg Lamictal/day. I also took extra folic acid, 4 mcg/day. I was concerned with taking two different meds at such a higher dose and wanted to wean off Dilantin to be on only one med. The Neurologist said it wouldn't do any good because any damage would have already been done by that point. I was still early in the pregnancy when he said that. (However I did switch doctors, so that may or may not be the case.) We scheduled an early c-section that went smoothly and my baby who is almost two is very healthy.

I really do believe that taking the meds is important while pregnant. Does your daughter have more seizures during her premenstrual cycle? That is almost the only time of the month when I have mine. You may want to discuss with her OB the options of having a possible early induction to avoid seizures at the very end of pregnancy when our hormones tend to go crazy.

I'm really sorry about the long post, but I hope it helps a little.

 

[dumbspouse]

Hey everyone! Well we found out last week that my wife is about a month along. It happened a little faster than what we thought, but it was still planned. Started out in June where her doctor ramped up her Lamictal and then weened her off the Tegretol. Once that was done she went off the birth control. Once both meds were out of her system, her neuro did a baseline Lamictal level. Word to the wise, here is the vicious cycle of meds. Tegretol will eat Lamictal and Birth Control, and the Birth Control will eat the Lamictal as well. So you can see where the neuro wanted the baseline Lamictal level. On another note she's on the generic Lamictal, with no problems at all. She was able to get an OB at OU (University of Oklahoma) where her nuero is at as well. I will try and keep you all updated on how this comes out. She's on the prenatals and folic acid as well. Has been for 3 years for just in case. She's been getting different storied on nursing with Lamictal.

 

[Nakamova]

Congrats dumbspouse! That's great news. Sounds like you and your wife are doing everything right. I hope things continue smoothly. Keep us posted!

 

[momof3boys]

Hi Bridget,

Im a mom of 3 healthy little boys. Ages 6, 5 and 4 yrs old. I have PCOS, polycystic Ovarian Syndrome, and was told at around the age of 18 that if I ever wanted kids, I would have to adopt. My periods were never coming, and if I did have one, it would come one month and then I wouldnt know when the next would show up.

In the Year 2003, I woke up one morning and something inside me was telling me to take a pregnancy test. I thought it was kind of odd for me to be thinking that, but It just kept bugging me, that I had to take one to get it off my mind. I took one, and it came up positive. I about crapped my pants! I was in engaged to be married the following year. I immediately went to the dr and had an blood test done, and then an ultra sound to be sure how far along I was. I turned out to be 3 months along. I freaked out. I was taking Keppra and Carbotrol I was a week away from being in my second trimester and I wasnt taking any folic acide or prenatal vitsamins. We had our first son in June 2004. He came out perfectly healthy. We then got pregnant by suprised six weeks after his birth. Our second son was born in May 2005. He also came out perfectly healthy. We wanted one more, and had our third son in November 2006. He also came out healthy too.

Being on those two medications, I was very thankful to have had all three kids come out with no problems and be healthy as they can ever be. Im sure that if I can have healthy kids, anyone else who has Epilepsy and takes medications can have healthy kids too.

 

[dumbspouse]

Last Friday was out first visit with the OB. I thought this appointment was just going to be a meet and great. The did an Ultrasound and the baby is almost 2cm long. As of last Friday, my wife is 8 1/2 weeks along. The doc said everything is progressing as normal and everything looks fine. The projected due date is 9/5/11

 

[dumbspouse]

I know I haven't been on here in a long while. Bradley was born on 14 Sep 2011 with no issues other than just being a big boy (9lbs 6oz). All I can say is stay on top the prenatal vitamins and folic acid.


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