Author N. Adab from the Department of Neurological Science at The Walton Centre for Neurology and Neurosurgery, in Liverpool, UK, wrote an article titled “Therapeutic Monitoring of Antiepileptic drugs During Pregnancy and in the Postpartum Period: is it Useful?”, where he states “As in all patient populations, epilepsy is common in pregnant women. Consequently, approximately 1 in 200 pregnancies is exposed to antiepileptic drugs (AEDs). Although exposure to AEDs in utero has been associated with an increased risk of major fetal malformations, most women with epilepsy require medication throughout pregnancy, since seizures themselves may be potentially harmful not only for the mother but also for the developing fetus.”
The use of more than one drug to treat epilepsy of pregnant women is associated with an increased risk for major congenital malformations in the offspring. Most doctors would strongly recommend the use of no more than one drug, however this is not always possible due to the fact that some women have epilepsy that in not well controlled with just one medication. Therefore, polytherapy and the risks involved with the treatment may be the only reasonable option for some women.
The author goes on: “Physiological changes during pregnancy result in a reduction in the serum concentrations of most AEDs, particularly in late pregnancy. Changes in protein binding lead to a greater reduction in total than free (active) drug concentrations. Pharmacokinetic changes in pregnancy show interindividual variability and are not well understood for most newer AEDs. However, recent studies have shown that changes in lamotrigine clearance are particularly marked, with increases in each trimester and a significant fall in plasma concentrations, leading to consequent breakthrough seizures in some women.”
Theoretically, the guided adjustment of antiepileptic drug dosage for good seizure control while minimizing fetal exposure is possible with therapeutic drug monitoring. One limitation to such monitoring may be for highly protein bound drugs, due to the fact that free drug concentrations may more accurately reflect drug availability during pregnancy than total drug concentrations.
In recent years, many studies such as this have been published showing the danger epileptic drugs pose to developing children, and some of them could be used as evidence in an AED birth defects lawsuit that manufacturers of AEDs knew, or should have known, the risks associated with their products. Since warning labels were not updated in light of the publication of research such as that summarized above, AED birth defects lawsuits, particularly Depacon lawsuits, have been filed around the world.
If you or a loved one used Depacon and your child was born with a congenital malformation, you may be entitled to significant financial compensation for the pain your family has endured. For more information on Depacon and Depacon lawsuits, contact our team of Depacon lawyers at your convenience.
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