Lamotrigine and Pregnancy: Changes of Serum Concentration and Seizure Frequency

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  • Ohtani Hideyuki
    National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders
  • Yamazaki Yetsuko
    National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders
  • Yoshimura Katsunari
    National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders
  • Shigematsu Hideo
    National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders
  • Hiyoshi Toshio
    National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders
  • Terada Kiyohito
    National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders
  • Inoue Yushi
    National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders

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  • 妊娠中のラモトリギンの血中濃度の変化および発作の悪化について

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Changes of serum concentration of lamotrigine (LTG) and seizure frequency during pregnancy were investigated in 16 pregnancies of 13 patients with epilepsy. 15 of 16 cases gave birth. There was no case with major fetal malformation. One patient died of drowning by seizure during bathing at 27 weeks of pregnancy. The average LTG doses before pregnancy were 216.7±60.6 mg in monotherapy group (6 cases) and 270.0±126.8 mg in polytherapy group (10 cases). The median blood concentration before pregnancy was 7.8 μg/ml, and the median rate of decrease of blood concentration during pregnancy was 62.35%. The LTG dose was increased during pregnancy in 43.75% and other antiepileptic drugs were added in 18.75% of cases. Generalized tonic-clonic seizures worsened in 4 cases and complex partial seizure appeared more often in 5 cases as compared to pre-pregnancy period. 25% of cases required LTG dose higher than that indicated in the package insert. Our data indicates a need of careful management of LTG in pregnant women with epilepsy to avoid aggravation of seizures.

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