拉莫三嗪的致畸性。
Teratogenicity of lamotrigine.
作者信息
Shor Sarit, Koren Gideon, Nulman Irena
出版信息
Can Fam Physician. 2007 Jun;53(6):1007-9.
QUESTION
One of my female patients has epilepsy and is currently receiving lamotrigine monotherapy. She has recently found that she is 6 weeks pregnant and is concerned about possible side effects of lamotrigine on her fetus. How should I advise her and should I switch to another antiepileptic drug?
ANSWER
Lamotrigine (LTG) has not been associated with an increased risk for major malformations in monotherapy in most available studies. Risk of major malformations has been suggested when LTG was taken in doses higher than 200 mg/d and when clefts not caused by any known syndrome have been associated with LTG treatment. Therefore, safety for the fetus cannot yet be proven or rejected, although the drug does not appear to be a major human teratogen.
问题
我的一位女性患者患有癫痫，目前正在接受拉莫三嗪单药治疗。她最近发现自己怀孕6周了，担心拉莫三嗪对胎儿可能产生的副作用。我应该如何建议她，是否应该换用另一种抗癫痫药物？
答案
在大多数现有研究中，拉莫三嗪（LTG）单药治疗与主要畸形风险增加无关。当拉莫三嗪剂量高于200mg/天时，以及当与拉莫三嗪治疗相关的并非由任何已知综合征引起的腭裂出现时，提示存在主要畸形风险。因此，尽管该药物似乎不是主要的人类致畸剂，但胎儿的安全性尚未得到证实或排除。
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