Lamotrigine is used to treat epilepsy, sometimes in combination with other medicines. Lamotrigine is also occasionally used in the treatment of bipolar disorder. Antiepileptic drugs are associated with an increased risk of teratogenicity (the risk is decreased with monotherapy). Increased risk of congenital malformations is itself associated with epilepsy .

It is recommended that pregnant women and women who are planning to become pregnant should be referred to a specialist and apprised of the potential hazards to the fetus.

​Lamotrigine During Pregnancy: Things You Need to Know

Is it safe to take lamotrigine during pregnancy?

There is no yes or no answer to this question. It is important to weigh up how necessary lamotrigine is to your health against the possible risks to you or your baby depending upon how many weeks pregnancy.

Epilepsy should be well-controlled during pregnancy as seizures can harm both mother and unborn child.Doctor is the best person to help you decide what is right for you and your baby.

Recommendations

For a baby’s growth and development in the womb folic acid is necessary. Women taking lamotrigine (or any other antiepileptic medicine) also take high dose folic acid (5mg/day) instead of the standard dose of 400mcg whilst trying to conceive and during the first trimester of pregnancy.

Doctor prescribes a high folic acid dose . Medical researches show whether high dose folic acid is any better than the standard dose, however, until more scientific information is available high dose folic acid is advised in pregnant women who are taking these medicines.

Can lamotrigine in pregnancy cause birth defects in the baby?

The first 12 weeks of pregnancy baby’s body and the internal organs are forming. During this time that some medicines are known to cause birth defects.

Lamotrigine is sometimes taken in combination with other medicines to treat epilepsy. Some studies have shown that women taking combinations of antiepileptic medicines may be more likely to have a baby with a birth defect than women taking a single antiepileptic medicine.

To control epilepsy if you are taking more than one medicine you should discuss any concerns that you may have with your doctor. The dose of any medicine you are taking should not to be altered without first speaking to your doctor.

Can taking lamotrigine in pregnancy cause miscarriage, stillbirth, or preterm birth?

No links between lamotrigine use in pregnancy and miscarriage, stillbirth, or preterm birth are known about, although no scientific studies have been carried out that have specifically investigated these pregnancy outcomes.

Can taking lamotrigine in pregnancy cause other health problems in the child?

Withdrawal symptoms at birth (‘neonatal withdrawal’)

Other medicines that are known to cause neonatal withdrawal lamotrigine works in the similar way, therefore close monitoring of your baby for a few days after birth may be suggested. Keeping your baby in supervision may be particularly important if you have taken lamotrigine in combination with other antiepileptic medicines or medicines that act on the brain.

Learning and behavioural problems

Right up until the end of pregnancy baby’s brain continues to develop. Taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

Few researches have been carried out to look at whether there is an increased risk of learning and behavioural problems in children who were exposed to lamotrigine while in the womb. These studies are summarised below:

ASD (Autism spectrum disorder ) ​- Two studies have investigated whether taking lamotrigine during pregnancy is linked to having a child with ASD. For the confirmation of the studies larger numbers of children exposed to lamotrigine in the womb need to be studied before we can say whether there is any link with ASD.

ADHD (Attention deficit hyperactivity disorder ) ​- None of three studies have shown a link between use of lamotrigine in pregnancy and ADHD in the child.

​Thinking and learning skills ​- Four studies compared different learning and thinking abilities of children who were exposed to lamotrigine in the womb with children not exposed to lamotrigine. All inclusive , these researches provide no strong evidence of any major differences in IQ, communication and memory. However, these types of studies are very difficult to carry out and may not produce reliable results if too few children are studies.

Results are generally reassuring, because only small numbers of children have been studied, much more research is required before we can say whether lamotrigine use in pregnancy can result in changes in coordination, movement, learning and behaviour in exposed children.