Pharmacy Practice NewsExposure to Anti-Seizure Medications Does Not Appear to Harm Neurologic Development in Young Children

New Study Reassures Mothers and Guides Neurologists on Prescribing Practices

A recent study published in Lancet Neurology offers comforting news to women with epilepsy who are considering pregnancy. The research indicates that commonly prescribed anti-seizure medications like lamotrigine and levetiracetam do not negatively impact the neurodevelopment of children exposed to these drugs in utero.

HCN Medical Memo
This study provides a valuable evidence base for advising women with epilepsy who are considering pregnancy. The research alleviates concerns about the neurodevelopmental risks associated with commonly used anti-seizure medications, allowing for more informed and nuanced prescribing practices. However, it also underscores the need for careful monitoring of medication dosages, particularly in the third trimester, and for addressing maternal mental health as a part of comprehensive prenatal care.

Key Points

• The study, known as the MONEAD (Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs), has been ongoing for two decades and focuses on the impact of anti-seizure medications on both mothers and their children.
• Children exposed to lamotrigine and levetiracetam in utero showed no significant differences in vocabulary, verbal comprehension, or cognitive abilities compared to children of women without epilepsy.
• Senior author Page Pennell, MD, emphasized that the findings have “a huge impact for women with epilepsy who are considering pregnancy.”
• Epilepsy affects more than 1 million American women of childbearing age, making these findings particularly relevant.

“Being able to say that no, taking these medications will not put their future child at a greater risk of autism or learning disabilities, has a huge impact for women with epilepsy who are considering pregnancy.”
– Page Pennell, MD, Senior Author and Professor and the Chair of Neurology at the University of Pittsburgh

Additional Points

• High dosages of levetiracetam in the third trimester were correlated with some adverse neurodevelopmental effects, warranting careful monitoring.
• The study also highlighted the importance of screening for maternal mood and anxiety disorders, as they can negatively affect newborns.
• Further research is needed to assess the long-term effects of less commonly used anti-seizure medications.

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