Antiepileptic drug use in women of childbearing age

• Type of Material: Article
• Authors: Kimford J. Meador, Emory University; Patricia Penovich, Minnesota Epilepsy Group; Gus A. Baker, University of Liverpool; Page B. Pennell, Emory University; Edward Bromfield, Harvard–Brigham & Women's; Alison Pack, Columbia University; Joyce D. Liporace, Riddle Health Care; Maria Sam, Wake Forest University; Laura A. Kalayjian, University of Southern California, Los Angeles; David J Thurman, Emory University; Eugene Moore, Emory University; David W. Loring, Emory University; David W Loring, Emory University
• Language: English
• Date: 2009-07
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.yebeh.2009.04.026
• Title of Journal or Parent Work: Epilepsy and Behavior
• ISSN: 1525-5050
• Volume: 15
• Issue: 3
• Start Page: 339
• End Page: 343
• Grant/Funding Information: This study was supported by Grants 2 RO1 NS038455 from the NIH/NINDS, 1 R01050659 from the NIH/NINDS, and RB219738 from the UK Epilepsy Research Foundation.; National Institute of Neurological Disorders and Stroke : NINDS
• Keywords: Women; Prescription practices; Pregnancy; Drug choice; Antiepileptic drugs; Epilepsy; Teratogenesis
• Research Categories: Biology, Neuroscience

Abstract

Research on antiepileptic drug (AED) teratogenesis has demonstrated an increased risk for valproate. The impact of these findings on current AED prescribing patterns for women of childbearing age with epilepsy is uncertain. The Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) Study is an ongoing prospective multicenter observational investigation that enrolled pregnant women with epilepsy on the most common AED monotherapies from October 1999 to February 2004 (carbamazepine, lamotrigine, valproate, and phenytoin). A 2007 survey of AED use in women of childbearing age at eight NEAD centers found a total of 932 women of childbearing age with epilepsy (6% taking no AED, 53% monotherapy, 41% polytherapy). The most common monotherapies were lamotrigine or levetiracetam. Since 2004, prescriptions of carbamazepine, phenytoin, and valproate have decreased, whereas those for levetiracetam have increased. Except for the top two AED monotherapies, there were marked differences in other monotherapies and in polytherapies between U.S. and UK centers. Future investigations are needed to examine reasons for drug choice.