Berwaerts K, Sienaert P, De Fruyt J
Psycho-Sociaal Centrum Leuven en Universitair Psychiatrisch Cetrum, Katholieke Universiteit Leuven, campus Kortenberg.
Tijdschr Psychiatr. 2009;51(10):741-50.
There is some doubt whether medication for women who have bipolar disorder and are pregnant should be adjusted during pregnancy or following childbirth. It is possible that adjustment during pregnancy may damage the foetus. Lithium is hardly teratogenic, whereas carbamazepine and valproic acid are teratogenic. The anticonvulsant lamotrigine is also used regularly to treat or prevent bipolar depressive episodes.
To provide an overview of the available literature concerning the prevention of congenital malformations following the use of lamotrigine (LMT) during pregnancy.
The Medline database was searched using the search terms: 'pregnancy register' and ('lamotrigine' [Substance name] or 'anticonvulsants'[MeSH]) .
Ten studies and birth registers were selected which reported data concerning the use of LMT by women with epilepsy. There were no data concerning the use of LMT during the pregnancy of women with a bipolar disorder. The risk of a major congenital malformation (MCM) for LMT varied between 1 and 4.0%.
There are no strong indications that the use of LMT during pregnancy results in an increased number of major congenital malformations.
对于患有双相情感障碍的孕妇，孕期或产后是否应调整用药存在一些疑问。孕期调整用药可能会损害胎儿。锂盐几乎没有致畸性，而卡马西平和丙戊酸具有致畸性。抗惊厥药物拉莫三嗪也经常用于治疗或预防双相抑郁发作。
综述关于孕期使用拉莫三嗪（LMT）后预防先天性畸形的现有文献。
使用检索词“妊娠登记”和（“拉莫三嗪”[物质名称]或“抗惊厥药”[医学主题词]）检索Medline数据库。
选择了10项研究和出生登记，这些研究报告了癫痫女性使用LMT的数据。没有关于双相情感障碍女性孕期使用LMT的数据。LMT导致重大先天性畸形（MCM）的风险在1%至4.0%之间。
没有有力证据表明孕期使用LMT会导致重大先天性畸形数量增加。
