This sheet is about exposure to lamotrigine in pregnancy and while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.
What is lamotrigine?
Lamotrigine is a medication that has been used to treat bipolar disorder, some types of seizures, and Lennox-Gastaut syndrome (a severe form of epilepsy). A brand name for lamotrigine is Lamictal®.
Sometimes when people find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
Having a seizure while pregnant could be harmful to a pregnancy. People who have bipolar disorder and stop taking their medication are at increased risk for episodes of depression or mania that may be harmful to both the person who is pregnant and the pregnancy. For more information on depression in pregnancy, please see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/depression-pregnancy/.
If your lamotrigine dose is increased during pregnancy, talk with your healthcare provider about how and when to lower your dose after delivery.
I take lamotrigine. Can it make it harder for me to get pregnant?
One study suggested lamotrigine might make it harder to get pregnant. Having a seizure disorder, as well as long-term use of seizure medications, might be associated with irregular periods and hormonal disorders which could lead to a harder time getting pregnant (infertility).
Does taking lamotrigine increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not found that lamotrigine is associated with a higher chance of miscarriage.
Does taking lamotrigine increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. One study suggested a less than 1% (less than 1 in 100) increase in oral clefts such as cleft lip and/or palate (an opening in the upper lip or the roof of the mouth) with the use of lamotrigine in the first trimester of pregnancy. However, this finding was not confirmed by other studies. Also, several studies looking at several thousand pregnancies have found no increased chance of birth defects when lamotrigine is taken during pregnancy.
Does taking lamotrigine in pregnancy increase the chance of other pregnancy-related problems?
Use of lamotrigine in pregnancy has not been associated with an increased chance for other pregnancy complications, such as preterm delivery (birth before week 37) or poor growth of the fetus (small size, low birth weight, or smaller head measurement).
Does taking lamotrigine in pregnancy affect future behavior or learning for the child?
Several studies have looked at the development of babies and children who were exposed to lamotrigine during pregnancy. Most of these studies did not find differences in behavior or learning between babies exposed to lamotrigine and those who were not.
Breastfeeding while taking lamotrigine:
Lamotrigine passes into breast milk. The amount of lamotrigine in breastmilk is usually much lower than the amount that would be given to a baby directly to control seizures. Most infants who are exposed to lamotrigine in breastmilk are not expected to have side effects. There have been case reports of breastfed infants with breathing problems and anemia (low red blood cell counts).
Babies can be watched for possible side effects, such as a rash, trouble breathing, sleepiness, or poor sucking. If the baby develops any symptoms, especially a rash, contact your healthcare provider and your child’s healthcare provider right away. They will talk with you about using lamotrigine and the best way to treat your condition while breastfeeding. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If your lamotrigine dose was increased during pregnancy, talk with your healthcare provider about how and when to lower your dose after delivery.
If a male takes lamotrigine, could it affect fertility or increase the chance of birth defects?
In a small number of studies, lamotrigine has not been shown to affect sperm counts, motility (movement of the sperm), or male sex hormones. Studies have shown that males with seizure disorders or bipolar disorder may have lower fertility (ability to get partner pregnant). In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
Please click here for references.
National Pregnancy Registry for Psychiatric Medications: There is a pregnancy registry for women who take psychiatric medications, such as lamotrigine. For more information you can look at their website: https://womensmentalhealth.org/research/pregnancyregistry/.
North American Antiepileptic Drug (AED) Pregnancy Registry: There is a pregnancy registry for women who take antiepileptic medications, such as lamotrigine. For more information you can look at their website: http://www.aedpregnancyregistry.org/.
OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.
