Clinical features of the use of lamotrigine in pregnant women with epilepsy | Ukrainian Medical Journal

In order to study the existing world experience in the clinical use of lamotrigine as one of the most commonly prescribed antiepileptic drugs for women with epilepsy, including during pregnancy, as well as to provide practically significant recommendations on the peculiarities of its use to practicing neurologists, we carried out an information search articles and abstracts in the MEDLINE, The Cochrane Library, Google Scholar databases as of December 31, 2019 using keywords «safety», «antiepileptic drugs», «epilepsy», «pregnancy», «lamotrigine», «seizures», «congenital abnormalities». It was found that lamotrigine is one of the safest drugs for the treatment of epilepsy in women. The features of its use were studied and five of the most important, from our point of view, clinical recommendations to optimize the therapy are presented: a gradual transition to monotherapy with lamotrigine at the stage of pregnancy planning, taking high doses (5 mg) of folic acid from 3 months before conception to the end of the I trimester of pregnancy, regular clinical examination and monitoring of the drug in plasma, dose adjustment of lamotrigine in every trimester of pregnancy and a reduction in dosage after childbirth, avoiding breastfeeding of the newborn with a careful assesment of potential benefits and the possible risk of side effects.

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