Gestation-induced changes in lamotrigine pharmacokinetics: a monotherapy study.
The authors describe 12 pregnancies in women with epilepsy using lamotrigine (LTG) monotherapy. A seizure increase in nine pregnancies was probably related to a gradual decline of LTG level-to-dose ratio to 40% of baseline. After delivery, LTG kinetics returned swiftly to baseline, causing toxic side effects in some women. Frequent LTG level monitoring and appropriate dose adjustments are advised in the period before and during pregnancy and after delivery, especially in women on LTG monotherapy.
de Haan
G-J
GJ
Department of Neurology and Epileptology, Epilepsy Institute of the Netherlands SEIN, Heemstede, The Netherlands. gjdhaan@sein.nl
Edelbroek
P
P
Segers
J
J
Engelsman
M
M
Lindhout
D
D
Dévilé-Notschaele
M
M
Augustijn
P
P
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D000077213:Lamotrigine; D008895:Milk, Human / Q000737:chemistry; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000188:drug therapy / Q000378:metabolism*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012008:Recurrence; D012189:Retrospective Studies; D014227:Triazines / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*
D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine