MotherToBaby

Medications and More during pregnancy and breastfeeding

Search

866.626.6847

Lamotrigine (Lamictal®)

Selected References:

  • Almgren M, et al. 2009. Population-based study of antiepileptic drug exposure in utero–influence on head circumference in newborns. Seizure, 18(10):672-5.
  • Arfman IJ, et al. 2020. Therapeutic drug monitoring of antiepileptic drugs in women with epilepsy before, during, and after pregnancy. Clin Pharmacokinet, 59(4):427-445.
  • Asranna A, et al. 2018. Do anti-epileptic drug modifications after first trimester of pregnancy influence fetal malformation or cognitive outcome? Epilepsy Research, 146: 121-125.
  • Ban L, et al. 2015. Congenital anomalies in children of mothers taking antiepileptic drugs with and without periconceptional high dose folic acid use: a population-based cohort study. PLoS One, 10(7): e0131130.
  • Bech LF, et al. 2018. In utero exposure to antiepileptic drugs is associated with learning disabilities among offspring. Journal of Neurology, Neurosurgery & Psychiatry, 89(12): 1324-1331.
  • Birnbaum AK, et al. 2020. Antiepileptic drug exposure in infants of breastfeeding mothers with epilepsy. JAMA Neurology, 77(4): 441-450.
  • Bjork MH, et al. 2022. Association of prenatal exposure to antiseizure medication with low risk of autism and intellectual disability. JAMA Neurology, 79(7)672-681.
  • Blotière PO, et al. 2019. Risks of 23 specific malformations associated with prenatal exposure to 10 antiepileptic drugs. Neurology, 93(2):e167-e180.
  • Borthen I. 2015. Obstetrical complications in women with epilepsy. Seizure, 28: 32-34.
  • Bromley RL, et al. 2013. The prevalence of neurodevelopmental disorders in children prenatally exposed to antiepileptic drugs. Journal of Neurology, Neurosurgery & Psychiatry, 84(6): 637-643.
  • Bromley RL, et al. 2018. Fetal antiepileptic drug exposure and cognitive outcomes. Seizure, 44:225–231.
  • Bromley R, et al. 2022. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database of Systematic Reviews, 8(8):CD010224.
  • Bromley RL, et al. 2023. Neurodevelopment of babies born to mothers with epilepsy: a prospective observational cohort study. Epilepsia, 64:2454-2471.
  • Clark CT, Wisner KL. 2018. Treatment of Peripartum Bipolar Disorder. Obstet Gynecol Clin North Am, 45(3):403-417.
  • Cohen‐Israel M, et al. 2018. Short‐and long‐term complications of in utero exposure to lamotrigine. British Journal of Clinical Pharmacology, 84(1): 189-194.
  • Cohen JM, et al. 2019. Anticonvulsant mood stabilizer and lithium use and risk of adverse pregnancy outcomes. J Clin Psych, 80(4):18m12572.
  • Cohen JM, et al. 2023. Comparative safety of antiseizure medication monotherapy for major malformations. Ann Neurol, 93:551-562.
  • Coste J, et al. 2020. Risk of neurodevelopmental disorders associated with in utero exposure to valproate and other antiepileptic drugs: a nationwide cohort study in France. Scientific Reports, 10(1):17362.
  • Cummings C, et al. 2011. Neurodevelopment of children exposed in utero to lamotrigine, sodium valproate and carbamazepine. Archives of Disease in Childhood, 96(7):643-647.
  • Deshmukh U, et al. 2016. Behavioral outcomes in children exposed prenatally to lamotrigine, valproate, or carbamazepine. Neurotoxicol Teratol, 54:5-14.
  • Diav-Citrin O, et al. 2017. Is it safe to use lamotrigine during pregnancy? A prospective comparative observational study. Birth Defects Res 1,09:1196-1203.
  • Dolk H, et al. 2008. Does lamotrigine use in pregnancy increase orofacial cleft risk relative to other malformations? Neurology, 71:714-722.
  • Dolk H, et al. 2016. Lamotrigine use in pregnancy and risk of orofacial cleft and other congenital anomalies. Neurology, 86(18):1716-1725.
  • Dreier JW, et al. 2023. Prenatal exposure to antiseizure medication and incidence of childhood- and adolescence-onset psychiatric disorders. JAMA Neurology, 80(6):568-577.
  • Dudukina E, et al. 2023. Prenatal exposure to pregabalin, birth outcomes and neurodevelopment – a population-based study in four Nordic countries. Drug Safety, 46;661-675.
  • Fantaneau TA, et al. 2023. Real-world practices for the care of women with epilepsy during pregnancy: a Canadian perspective. Epilepsy and Behavior, 148:109468.
  • Gerard EE, et al. 2015. An update on maternal use of antiepileptic medications in pregnancy and neurodevelopment outcomes. Journal of Pediatric Genetics, 4(2):94-110.
  • Gómez-Ramiro M, et al. 2019. Adverse outcomes during pregnancy and major congenital malformations in infants of patients with bipolar and schizoaffective disorders treated with antiepileptic drugs: a systematic review. Psychiatr Pol, 53(2):223-244.
  • Harden CL, et al. 2009. Practice parameter update: management issues for women with epilepsy—focus on pregnancy (an evidence-based review): vitamin K, folic acid, blood levels, and breastfeeding: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology, 73:142–149.
  • Hernandez-Diaz S, et al. 2017. Fetal growth and premature delivery in pregnant women on antiepileptic drugs. Ann Neurol, 82(3):457-465.
  • Herzog AG, 2008. Disorders of reproduction in patients with epilepsy: primary neurological mechanisms. Seizure, 17(2):101-110.
  • Hoeltzenbein M, et al. 2024. Antiepileptic treatment with levetiracetam during the first trimester and pregnancy outcome: an observational study. Epilepsia, 65(1):26-36.
  • Holmes LB, et al. 2011. Fetal effects of anticonvulsant polytherapies. Arch Neurol, 68(10):1275-1281.
  • Huber-Mollema Y, et al. 2020. Neurocognition after prenatal levetiracetam, lamotrigine, carbamazepine or valproate exposure. Journal of Neurology, 267:1724-1736.
  • Huber-Mollema Y, et al. 2019. Behavioral problems in children of mothers with epilepsy prenatally exposed to valproate, carbamazepine, lamotrigine, or levetiracetam monotherapy. Epilepsia, 60:1069-1082.
  • Husebye ES, et al. 2018. Verbal abilities in children of mothers with epilepsy: association to maternal folate status. Neurology, 91:e811-21.
  • Jazayeri D, et al. 2018. Outcomes of pregnancies in women taking antiepileptic drugs for non-epilepsy indications. Seizure, 56: 111-114.
  • Kacirova I, et al. 2019. A short communication: lamotrigine levels in milk, mothers, and breastfed infants during the first postnatal month. Therapeutic Drug Monitoring, 41(3):401-404.
  • Kacirova I, et al. 2022. Monitoring of lamotrigine concentrations in mothers, colostrum, and breastfed newborns during the early postpartum period. Biomedicine and Pharmacolotherapy, 151:113167.
  • Khan SJ, et al. 2016. Bipolar disorder in pregnancy and postpartum: principles of management. Curr Psychiatry Rep, 18(2):13.
  • Kohn E, et al. 2022. Magnitude of lamotrigine exposure through breastfeeding. Breastfeeding Medicine, 17(4):341-348.
  • Kuczynska J, et al. 2019. Comparison of plasma, saliva, and hair lamotrigine concentrations. Clinical Biochemistry. 74:24-30.
  • Leutritz AL, et al. 2022. Psychotropic medication in pregnancy and lactation and development of exposed children. Br J Clin Pharmacol, 89(2):737-750.
  • Li Y, Meador KJ. 2022. Epilepsy and pregnancy. Continuum (Minneap Minn), 28(1):34-54.
  • MacEachern DB, et al. 2019. Infertility, impaired fecundity, and live birth/pregnancy ratio in women with epilepsy in the USA: findings of the Epilepsy Birth Control Registry. Epilepsia, 60(9):1993-1998.
  • McVearry KM, et al. 2009. A prospective study of cognitive fluency and originality in children exposed in utero to carbamazepine, lamotrigine, or valproate monotherapy. Epilepsy Behav, 16(4):609-616.
  • Meador K, et al. 2011. Foetal antiepileptic drug exposure and verbal versus non-verbal abilities at three years of age. Brain, 134:396-404.
  • Meador KJ, et al. 2014. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr, 168(8):729-736.
  • Montouris G, et al. 2005. Reproductive and sexual dysfunction in men with epilepsy. Epilepsy & Behavior, 7:7-14.
  • Mostacci B, et al. 2018. Emilia-Romagna study on pregnancy and exposure to antiepileptic drugs (ESPEA): a population-based study on prescription patterns, pregnancy outcomes and fetal health. J Neurol Neurosurg Psychiatry, 89:983–988.
  • American College of Obstetricians and Gynecologists. 2017. Neural tube defects. Practice Bulletin No. 187. Obstet Gynecol 130(6):e279–e290.
  • Newport DJ, et al. 2008. Lamotrigine in breast milk and nursing infants: determination of exposure. Pediatrics, 122(1):e223-231.
  • Nordmo E, et al. 2009. Severe apnea in an infant exposed to lamotrigine in breast milk. Ann Pharmacother, 43:1893-1897.
  • Ohman I, et al. 2000. Lamotrigine in pregnancy: pharmacokinetics during delivery, in the neonate, and during lactation. Epilepsia, 41:709-713.
  • Pariente G, et al. 2017. Pregnancy outcomes following in utero exposure to lamotrigine: a systematic review and meta-analysis. CNS Drugs, (6):439-450.
  • Paulzen M, et al. 2015. Lamotrigine in pregnancy – therapeutic drug monitoring in maternal blood, amniotic fluid, and cord blood. Int Clin Psychopharmacol, 30(5):249-254.
  • Pekoz MT, et al. Birth outcomes in pregnant women with epilepsy: A nationwide multicenter study from Türkiye. Epilepsia, 64:2310-2321.
  • Prakash C, et al. 2016. Maternal and fetal outcomes after lamotrigine use in pregnancy: a retrospective analysis from an urban maternal mental health centre in New Zealand. Psychopharmacol Bull, 46(2):63-69.
  • Razaz N, et al. 2017. Association between pregnancy and perinatal outcomes among women with epilepsy. JAMA Neurology, 74(8):983-991.
  • Ren T, et al. 2023. Prenatal carbamazepine exposure and academic performance in adolescents: a population-based cohort study. Neurology, 100(7):e728-e738.
  • Richards N, et al. 2019. Developmental outcomes at age four following maternal antiepileptic drug use. Epilepsy & Behavior, 93:73-79.
  • Rihtman T, et al. 2013. Developmental outcomes at preschool age after fetal exposure to valproic acid and lamotrigine: cognitive, motor, sensory and behavioral function. Reprod Toxicol, 41:115–125.
  • Semet M, et al. 2017. The impact of drugs on male fertility: a review. Andrology, 5(4):640-663.
  • Schmidt CT, et al. 2023. Transfer of anticonvulsants and lithium into amniotic fluid, umbilical cord blood & breast milk: a systematic review & combined analysis. Prog Neuropsychopharmacol Biol Psychiatry, 124:110733.
  • Shi X, et al. 2022. Effects of antiepileptic drugs polytherapy on pregnancy outcomes in women with epilepsy: an observation study in northwest China. Epilepsy Behav, 135:108904.
  • Thomas SV, et al. 2017. Malformation risk of antiepileptic drug exposure during pregnancy in women with epilepsy: results from a pregnancy registry in South India. Epilepsia, 58:274–281.
  • Thomas SV, et al. 2022. Differential impact of antenatal exposure to antiseizure medications on motor and mental development in infants of women with epilepsy. Discord, 24(3):531-540.
  • Tomson T, et al. 2011. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. Lancet Neurol, 10(7):609-617.
  • Tomson T, et al. 2018. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet neurol, 17(6):530-538.
  • Tomson T, et al. 2019. Declining malformation rates with changed antiepileptic drug prescribing: an observational study. Neurology, 93(9):e831-e840.
  • Vajda FJ, et al. 2013. Lamotrigine in epilepsy, pregnancy and psychiatry–a drug for all seasons? Journal of Clinical Neuroscience. 20(1):13-16.
  • Vajda FJ, et al. 2019. Antiepileptic drugs and foetal malformation: analysis of 20 years of data in a pregnancy register. Seizure, 65:6-11.
  • Veiby G, et al. 2013. Early child development and exposure to antiepileptic drugs prenatally and through breastfeeding: a prospective cohort study on children of women with epilepsy. JAMA Neurol, 70:1367-1374.
  • Veiby G, et al. 2015. Epilepsy and recommendations for breastfeeding. Seizure, 28:57-65.
  • Velez-Ruiz NJ, et al. 2015. Neurodevelopmental effects of fetal antiepileptic drug exposure. Drug Safety, 38(3): 271-278.
  • Veroniki AA, et al. 2017. Comparative safety of anti-epileptic drugs during pregnancy: a systematic review and network meta-analysis of congenital malformations and prenatal outcomes. BMC Medicine, 15(1):95.
  • Vieta E, et al. Lamotrigine efficacy, safety, and tolerability for women of childbearing age with bipolar disorder: meta-analysis from four randomized, placebo-controlled maintenance studies. European Neuropsychopharmacology, 78:81-92.
  • Wakil L, et al. 2009. Neonatal outcomes with the use of lamotrigine for bipolar disorder in pregnancy and breastfeeding: a case series and review of the literature. Psychopharmacol Bullb 42:91-98.
  • Wiggs KK, et al. 2020. Antiseizure medication use during pregnancy and risk of ASD and ADHD in children. Neurology, 95;e3232-e3240.
  • Yeh TC, et al. 2021. Bipolar women’s antepartum psychotropic exposure and offspring risk of attention-deficit/hyperactivity disorder and autism spectrum disorder. Journal of Affective Disorders, 295:1407-1414.

This website is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,000,000 with zero percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS, or the U.S. Government.