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Study Indicates Epilepsy Drug Birth Defect Risk Could be Mitigated

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The risk of epilepsy drugs causing birth defects could now be easier to avoid, says a recent study. Researchers sought to determine the risks of major birth defects after exposure to four major antiepileptic drugs at different doses in the recent study published in Lancet Neurology.

In the 1960s, the link between epilepsy drugs and birth defects became a high priority; however, doctors faced the challenge of selecting the correct drug for women of childbearing age without exposing them to the risk of seizures, reported BBC News.

The study includes data from EURAP, an international epilepsy and pregnancy registry, consisting of physicians from 42 countries and more than 16,100 registered pregnancies. Researchers observed 3,909 women and 4,540 pregnancies exposed to monotherapy with different doses carbamazepine (Tegretol), lamotrigine (Lamictal), valproic acid (Depakote) or phenobarbital.

Results revealed “230 pregnancies involved major birth defects, including heart defects and neural tube defects such as spina bifida,” reported BBC News. Researchers concluded none of the tested drugs were in the clear because as the dose increased so did the risk. The lowest risk involved smaller doses of carbamazepine and lamotrigine.

Despite the drug used the majority of births were “perfectly healthy children,” says BBC News. Researchers also noted dose selection is equally important as the drug selected.

Although current information on prenatal exposure to antiepileptic drugs is inadequate, Professor W. Allen Hauser from Columbia University stated “the findings were ‘important’ because they offered alternatives to drugs linked most strongly to problems.”

“The results would be useful to GPs [general practitioners] with a specialist interest in epilepsy and hospital neurologists…,” said Professor John Duncan, Medical Director at the Epilepsy Society. He warned controlling seizures should remain the main priority, even during pregnancy.

“This research helps to clarify the extent of the risks involved with these drugs – and all drugs carry some degree of risk,” he said.

According to BBC News, in earlier studies the drug valproic acid was most linked to birth defects.

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