Changing patterns of antiepileptic drug use in pregnant Australian women.
OBJECTIVE
To trace the pattern of antiepileptic drug (AED) use in pregnant Australian women annually from 1999 to 2007, and correlate it with the pattern of AED use in the wider community.


METHODS
Analysis of data from the Australian Register of AEDs in Pregnancy, related to Australian population data for AED prescriptions.


RESULTS
Over the study period, prescribing of carbamazepine, phenytoin and valproate for pregnant women decreased, and prescribing of lamotrigine, topiramate and levetiracetam increased. These changes tended to parallel prescribing trends in the wider community, except for valproate, whose prescribing in the overall community increased as its prescribing, and its dosage prescribed, decreased in pregnancy. Concomitant with this, there was a trend towards fewer births of foetuses with abnormalities.


CONCLUSIONS
While otherwise following national AED prescribing trends, Australian prescribers are reducing the use and dose of valproate in pregnant women, likely in recognition of the teratogenic hazards of this drug.
Vajda
F J E
FJ
Department of Medicine and Neurosciences, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia. vajda@netspace.net.au
Hollingworth
S
S
Graham
J
J
Hitchcock
A A
AA
O'Brien
T J
TJ
Lander
C M
CM
Eadie
M J
MJ
D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001315:Australia; D000013:Congenital Abnormalities; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D016014:Linear Models; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012042:Registries; D014635:Valproic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D000927:Anticonvulsants; D014635:Valproic Acid