The risk of fetal malformations is a considerable therapeutic consideration in pregnant patients that suffer epilepsy. the need to control seizures effectively is counterbalanced by toxicity of medications. While lamotrigine was considered as a safer option than other anti-epiletics, doubt was cast upon this assertion. In this issue of JNNP, an important study conducted by Campbell and colleagues elegantly demonstrate that lamotrigine is safer that than valporate and tegretol. Indeed, valporate seemed to bear the highest risk of malformations. Of relevance, higher dose lamotrigine (>400 mg) did not seem to impart a significant increase of risk. Anyone managing epilepsy patients with the potential of falling pregnant must read this very important article.
- Research paper