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Emory researcher examines effects of antiepileptic drugs on pregnant women and their offspring

pregnant. The four medications being studied are carbamazepine (Tegretol, Tegretol-XR, Carbatrol), lamotrigine (Lamictal), phenytoin (Dilantin) and valproate (Depakote).

In the study, funded by the National Institutes of Health, nearly 350 mother/child pairs were enrolled at 28 centers in the U.S. and U.K. Emory enrolled 29 pairs. With over a year left in the study to record and analyze the effects of the drugs, researchers are already seeing significant data related to complications with these medications. The percentages of children with birth defects, developmental disabilities or death for each AED were as follows: carbamazepine 10 percent, lamotrigine two percent, phenytoin seven percent, and valproate 28 percent.

"While our numbers are still preliminary, we are learning that some of the newer AEDs, like lamotrigine, cause less harm to the child, while it looks like others cause more damage," says Dr. Pennell, who is leading the NEAD study at Emory University. " We will have to wait until the study is complete, however, to know exactly which medications are best for fetal development."

Researchers are also learning that effects of AEDs in offspring may not be so instant. "We are recognizing that we need to not only be concerned about birth defects from the AEDs, but also about cognitive effects later in the child's life," says Dr. Pennell. "At two years of age, we are realizing some of these children are experiencing speech delays, delays in walking and difficulties with fine motor skills. This study should help us notice the subtle differences in a child's ability to learn, and it should help us understand how to best care for pregnant women and their children." The NEAD study looks at the child's actual IQ vs. its predicted IQ based on parental testing.

The researchers are expanding this study to examine how AEDs cross into the fetus and exactly how much of the medications are absorbed (see next release). They also hope to follow all chi
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Contact: Janet Christenbury
jmchris@emory.edu
404-727-8599
Emory University Health Sciences Center
28-Apr-2004


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