妊娠中の抗てんかん薬としてのラモトリギン
Frank J E Vajda1, Terence J O'Brien2, Janet E Graham3
1Departments of Medicine and Neurosciences, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria 3050, Australia; Department of Neuroscience, Monash University, Melbourne, VIC 3004, Australia.
Aim:
To try to ascertain in APR data why lamotrigine was the preferred ASM in treating women with epilepsy, METHOD: Statistical analysis of foetal malformation and seizure free pregnancy occurrence rates associated with lamotrigine use in monotherapy and polytherapy RESULTS: Among commonly used ASMs, lamotrigine (4.6%) and levetiracetam (4.5%) in monotherapy had the lowest associated foetal malformation rates, compared with a 3.2% rate in ASM-untreated pregnancy in women with epilepsy. The lamotrigine monotherapy seizure freedom rate during pregnancy (56.6%) was lower than that associated with all other ASM monotherapy combined (68.7%; R.R. 1.21, 95% C.I. 1.12, 1.32).
Conclusion:
Those prescribing ASM therapy for women capable of pregnancy seem to have given priority to avoiding foetal malformation over achieving seizure freedom in pregnancy.
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