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Related Experiment Video

Updated: Oct 23, 2025

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Lacosamide serum concentrations during pregnancy.

Deepti Zutshi1, Scott R Millis2, Maysaa M Basha1

  • 1Comprehensive Epilepsy Center, Department of Neurology, Wayne State University, Detroit, MI, USA.

Epilepsy & Behavior : E&B
|August 16, 2021
PubMed
Summary

Pregnancy significantly lowers lacosamide (LCM) levels in women with epilepsy, particularly in the second and third trimesters. This study found no increased seizure risk or teratogenic effects in newborns exposed to LCM during gestation.

Keywords:
All Epilepsy/seizures [60]Antiepileptic drugs [61]Pregnancy

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Area of Science:

  • Pharmacology
  • Obstetrics
  • Neurology

Background:

  • Lacosamide (LCM) is an anti-seizure drug (ASD) with unknown teratogenicity in pregnancy.
  • Pregnancy may alter LCM metabolism, potentially reducing serum levels and increasing seizure risk in women with epilepsy (WWE).

Purpose of the Study:

  • To investigate the impact of pregnancy on serum lacosamide levels in women with epilepsy.

Main Methods:

  • A case series of seven pregnancies with lacosamide exposure was analyzed.
  • Serum lacosamide levels were measured during pregnancy and compared to pre-pregnancy values.
  • Dose-normalized concentrations (DNC) were calculated to account for dosage adjustments.

Main Results:

  • Serum LCM DNC significantly decreased over the course of pregnancy (p=0.002).
  • DNC was significantly lower in the second (p=0.001) and third (p=0.004) trimesters compared to pre-pregnancy levels.
  • No significant changes in seizure frequency were observed, and no teratogenic findings were noted in neonates.

Conclusions:

  • Pregnancy is associated with significantly decreased serum lacosamide levels, particularly in the second and third trimesters.
  • Current findings suggest lacosamide may be safe during pregnancy regarding teratogenicity and seizure control, but requires further investigation.