Dao Kim, Diezi Léonore, Haefliger David, Novy Jan, Girardin François R, Winterfeld Ursula
Swiss Teratogen Information Service, Service de pharmacologie clinique, Département de médecine, Centre hospitalier universitaire vaudois, 1011 Lausanne.
Service de neurologie, Département des neurosciences cliniques, Centre hospitalier universitaire vaudois, 1011 Lausanne.
Rev Med Suisse. 2025 Jan 15;21(900-1):77-80. doi: 10.53738/REVMED.2025.21.900-1.77.
The 2023-2024 updates on teratovigilance, with a focus on antiseizure medications, highlight several key points. American medical societies have revised their recommendations: maintaining effective seizure control is essential for both maternal and fetal health; lamotrigine, levetiracetam, and oxcarbazepine are preferred first-line treatments, whereas valproic acid and topiramate should be avoided if possible. In March 2024, an update on topiramate indicated an increased risk of neurodevelopmental disorders with prenatal exposure. For autism spectrum disorders specifically, a recent study did not find evidence linking topiramate to autism spectrum disorder. Lastly, a potential risk of neurodevelopmental disorders in children with fathers who used valproic acid has been suggested, but remains unconfirmed.
2023 - 2024年致畸监测更新，重点关注抗癫痫药物，突出了几个关键点。美国医学协会修订了他们的建议：维持有效的癫痫控制对母婴健康都至关重要；拉莫三嗪、左乙拉西坦和奥卡西平是首选的一线治疗药物，而丙戊酸和托吡酯应尽可能避免使用。2024年3月，托吡酯的一项更新表明产前接触该药物会增加神经发育障碍的风险。具体而言，对于自闭症谱系障碍，最近的一项研究没有发现托吡酯与自闭症谱系障碍之间存在关联的证据。最后，有研究表明父亲使用丙戊酸的儿童存在神经发育障碍的潜在风险，但仍未得到证实。
