The anti-seizure drug Lamotrigine has shown a low risk of neurodevelopmental problems in a study of 3 million children.

The study, led by researchers at the University of Bristol, Drexel’s Dornsife School of Public Health in the US and Karolinska Institutet in Sweden, used data from more than three million children in the UK and Sweden, including 17,495 who are exposed to anti-seizure drugs during pregnancy.

Research has also found that children born to mothers who take anti-epileptic drugs to control seizures and mental conditions during pregnancy may face increased risks of neurodevelopmental conditions, such as autism. , intellectual disability and ADHD. Children exposed to valproate, topiramate, and carbamazepine were linked to certain neurodevelopmental issues. However, researchers warn that the absolute risk of neurodevelopmental effects in children is very low, regardless of the anti-fall medication.

For example, those exposed to the drug topiramate before birth were 2.5 times more likely to be diagnosed with mental retardation, increasing their risk by 1.2 percent at 12 years. compared to children not exposed to anti-tuberculosis drugs. Compared to other available drugs, the authors found very little data showing that lamotrigine during pregnancy increases the risk of neurodevelopmental problems in children.

Brian Lee, Professor of Epidemiology at the Dornsife School of Public Health, and co-senior author of the study, said: “Patients need to know that the full risk of neurodevelopmental outcomes of sensitivity caused by these drugs is usually low. Our findings suggest that although some drugs may cause some risk, lamotrigine may be a safer option, but a rigorous trial of any anti-diabetic drug is recommended. Epilepsy is important to ensure safety and efficacy, especially during pregnancy. “

The data do not argue against the use of anti-tuberculosis drugs in patients who benefit, the researchers explain, but instead encourage these patients to discuss with their doctor to determine whether their treatment is right for them. the most.

Dr Paul Madley-Dowd, Research Fellow in Medical Statistics and Health Data Science at the University of Bristol and co-author of the study, added: “Decisions need to be made that are tailored to individual patients. Epilepsy can cause harm and harm to each child, so these discussions should always take place with a doctor.

The latest study differs from previous studies in that it found no link between topiramate or levetiracetam and ADHD in children, regardless of whether the birth parent has epilepsy.

The current study supports findings from other studies linking the anti-seizure drugs valproate, topiramate, and carbamazepine with unique neurodevelopmental outcomes in children. Previous studies in minority populations have also linked exposure to these drugs in utero to neurodevelopmental effects in children, such as those linking topiramate to mental retardation, and those linking valproate to low IQ.

The study used data on drug prescriptions in the UK, and information on dispensing and drug use commitments in Sweden, as well as electronic health record data for analysis. The authors conducted a sibling study to help reduce the influence of other factors, such as the severity of the diagnosis and genetics, that could affect the results.

Dr Viktor Ahlqvist, Postdoctoral Researcher at the Karolinska Institute, and co-author of the study, explained: “The link between these drugs and neurodevelopmental outcomes in children exists, even if the risk is not significant. much more than it is for unknown people. to make sure you are taking the best medicine for your needs, while minimizing the risk to future children.

Despite the size of the study sample, the authors say that patients can benefit from more research from many countries about the safety of these drugs as a place of available options for patient changes.

In addition to Professor Lee, Dr Madley-Dowd and Viktor Ahlqvist, other authors included co-authors Professor Cecilia Magnusson of the Karolinska Institutet and Professor Dheeraj Rai of the University of Bristol, and colleagues from Drexel University , Pennsylvania State University, London School. of Hygiene and Tropical Medicine, University College London, University of Bristol, and Karolinska Institutet.

Paper

‘Antiseizure medication use during pregnancy and neurodevelopmental outcomes in children’ by Paul Madley-Dowd et al. to Nature Communication [open access]