Abstract
Recent information suggests that use of the antiepileptic drug topiramate in pregnancy may raise some concerns, especially if used in polytherapy. Moreover, data on the safety of this antiepileptic drug for the breastfed infant are very limited. However, use of topiramate may be unavoidable in women who wish to become pregnant but who have already experienced severe adverse reactions to antiepileptic medications considered relatively safe in this female condition. Hence, we describe the healthy outcome of a male infant exposed to topiramate through the placenta and maternal milk and who was conceived while the mother was undergoing folic acid supplementation.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Topamax. Indications and dosage [online]. Available from URL: http://http://www.rxlist.com/cgi/generic/topiram_ids.htm [Accessed 2008 Jul 7]
Schürks M, Diener HC, Goadsby P. Update on the prophylaxis of migraine. Curr Treat Options Neurol 2008; 10: 20–9
Doggrell SA. New indications for topiramate: alcohol dependency and binge-eating disorder. Expert Opin Pharmacother 2008; (5): 869-73
Baptista T, Elfakih Y, Uzcátegui E, et al. Pharmacological management of atypical antipsychotic-induced weight gain. CNS Drugs 2008; 22: 477–95
Diav-Citrin O, Shechtman S, Bar-Oz B, et al. Pregnancy outcome after in utero exposure to valproate: evidence of dose relationship in teratogenic effect. CNS Drugs 2008; 22: 325–34
Thomas SV, Ajaykumar B, Sindhu K, et al. Motor and mental development of infants exposed to antiepileptic drugs in utero. Epilepsy Behav 2008; 13(1): 229–36
Morrell MJ. The new antiepileptic drugs and women: efficacy, reproductive health, pregnancy, and fetal outcome. Epilepsia 1996; 37Suppl. 6: S34–44
Hoyme HE, Hauck L, Quinn D. Minor anomalies accompanying prenatal exposure to topiramate [abstract]. J Investig Med 1998; 46: 119A
Ohman I. Vitols S, Luef G, et al. Topiramate kinetics during delivery, lactation, and in the neonate: preliminary observations. Epilepsia 2002; 43(10): 1157–60
Vila Cerén C, Demestre Guasch X, Raspall Torrent F, et al. Topiramate and pregnancy: neonate with bone anomalies [in Spanish]. An Pediatr (Barc) 2005; 63(4): 363–5
Cissoko H, Jonville-Béra AP, Autret-Leca E. New antiepileptic drugs in pregnancy: outcome of 12 exposed pregnancy [in French]. Therapie 2002; 57(4): 397–401
Morrow J, Russell A, Guthrie E, et al. Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register. J Neurol Neurosurg Psychiatry 2006; 77(2): 193–8
Ornoy A, Zvi N, Arnon J, et al. The outcome of pregnancy following topiramate treatment: a study on 52 pregnancies. Reprod Toxicol 2008; 25(3): 388–9
Kwarta RF, Hulihan JF, Schmider J, et al. Pregnancy outcomes in topiramate-treated women [abstract]. Epilepsia 2006; 47Suppl. 4: 119
Hunt S, Russell A, Smithson WH, et al. Topiramate in pregnancy: preliminary experience from the UK Epilepsy and Pregnancy Register. Neurology 2008; 71: 272–6
Acknowledgements
No sources of funding were used to assist in the preparation of this case report. The author has acted as a consultant to Eli Lilly and Boehringer Ingelheim, and has an educational grant pending from Eli Lilly.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gentile, S. Topiramate in Pregnancy and Breastfeeding. Clin. Drug Investig. 29, 139–141 (2009). https://doi.org/10.2165/0044011-200929020-00008
Published:
Issue Date:
DOI: https://doi.org/10.2165/0044011-200929020-00008