Research at Emory University shows that monitoring the level of an epilepsy drug, called lamotrigine, in the blood helps reduce increased seizure activity and improve the overall health of pregnant women and their fetuses.
The findings are published Nov. 28 in the online edition of Neurology, the medical journal of the American Academy of Neurology.
The drug, taken by pregnant women with epilepsy because of its mild risk of birth defects, has been linked to increased seizure activity in up to 75 percent of pregnancies, according to some prior research studies.
“This is important data considering current treatment guidelines do not address how to dose epilepsy drugs once women become pregnant,” says study author Page Pennell, MD, associate professor of neurology, Emory University School of Medicine, and director of the Emory Epilepsy Program.
For the study, 53 women taking lamotrigine underwent therapeutic drug monitoring every one-to three-months throughout their pregnancies.
Dr. Pennell and her colleagues measured seizure activity and the amount of lamotrigine in the blood since past studies have shown lamotrigine levels significantly drop during pregnancy, causing seizures to worsen.
In the current study, the clearance of lamotrigine increased by 89 percent in the third trimester compared to non-pregnant levels. Dosages were adjusted depending on the lamotrigine blood levels with the goal of maintaining each patient's target concentration determined by pre-pregnancy information.