open access

Vol 51, No 3 (2017)
Case reports
Submitted: 2016-11-07
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Lacosamide during pregnancy and breastfeeding

Simona Lattanzi, Claudia Cagnetti, Nicoletta Foschi, Leandro Provinciali, Mauro Silvestrini
DOI: 10.1016/j.pjnns.2017.03.003
·
Neurol Neurochir Pol 2017;51(3):266-269.

open access

Vol 51, No 3 (2017)
Case reports
Submitted: 2016-11-07

Abstract

Background

The epilepsy treatment during pregnancy represents a balance between teratogenic hazard and seizure control. The aim of the study was to evaluate the safety and efficacy of lacosamide (LCS) during pregnancy and breastfeeding.

Methods

Patients referred to our Epilepsy Center for pregnancy planning who became pregnant while taking LCS were prospectively followed-up. Data on seizure frequency, side effects, pregnancy course, delivery and breastfeeding, birth outcome, congenital malformation and development of newborns were collected.

Results

Three cases of maternal exposure to LCS were reported. Treatment with LCS was continued throughout pregnancy and breastfeeding at a median daily dose of 400mg. Lacosamide was used as monotherapy in two patients and as add-on treatment in one woman. Seizure frequency did not change throughout pregnancy and two subjects remained seizure free. The median gestational age at delivery was 39 weeks. The median Apgar scores at 1 and 5min were 9 and 10, respectively; no major or minor congenital malformations were observed in the offspring. Normal developmental milestone were reached by all new-borns.

Conclusions

Worldwide pregnancy registries have provided consistent and increasing information about the efficacy and safety of the older antiepileptic drugs during gestation, while data are lacking for many of the newer generations. These cases could suggest a good level of efficacy and safety for LCS throughout pregnancy and breastfeeding and argue against teratogenic or toxic potentialities.

Abstract

Background

The epilepsy treatment during pregnancy represents a balance between teratogenic hazard and seizure control. The aim of the study was to evaluate the safety and efficacy of lacosamide (LCS) during pregnancy and breastfeeding.

Methods

Patients referred to our Epilepsy Center for pregnancy planning who became pregnant while taking LCS were prospectively followed-up. Data on seizure frequency, side effects, pregnancy course, delivery and breastfeeding, birth outcome, congenital malformation and development of newborns were collected.

Results

Three cases of maternal exposure to LCS were reported. Treatment with LCS was continued throughout pregnancy and breastfeeding at a median daily dose of 400mg. Lacosamide was used as monotherapy in two patients and as add-on treatment in one woman. Seizure frequency did not change throughout pregnancy and two subjects remained seizure free. The median gestational age at delivery was 39 weeks. The median Apgar scores at 1 and 5min were 9 and 10, respectively; no major or minor congenital malformations were observed in the offspring. Normal developmental milestone were reached by all new-borns.

Conclusions

Worldwide pregnancy registries have provided consistent and increasing information about the efficacy and safety of the older antiepileptic drugs during gestation, while data are lacking for many of the newer generations. These cases could suggest a good level of efficacy and safety for LCS throughout pregnancy and breastfeeding and argue against teratogenic or toxic potentialities.

Get Citation

Keywords

Epilepsy, Lacosamide, Seizures, Pregnancy

About this article
Title

Lacosamide during pregnancy and breastfeeding

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 3 (2017)

Pages

266-269

DOI

10.1016/j.pjnns.2017.03.003

Bibliographic record

Neurol Neurochir Pol 2017;51(3):266-269.

Keywords

Epilepsy
Lacosamide
Seizures
Pregnancy

Authors

Simona Lattanzi
Claudia Cagnetti
Nicoletta Foschi
Leandro Provinciali
Mauro Silvestrini

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