2016 Volume 34 Issue 1 Pages 3-9
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.
