From the Research
Lamictal (lamotrigine) can be used during pregnancy when the benefits outweigh the risks, but it requires careful medical supervision. For women with epilepsy or bipolar disorder, continuing Lamictal during pregnancy is often recommended as untreated maternal conditions may pose greater risks to both mother and baby than the medication itself 1. However, Lamictal has been associated with a small increased risk of oral clefts when taken during the first trimester. The medication may also need dose adjustments during pregnancy as blood levels can decrease due to physiological changes.
Key Considerations
- Women taking Lamictal who become pregnant should not stop the medication abruptly as this could trigger serious seizures or mood episodes.
- Instead, they should consult their healthcare provider immediately to develop an individualized treatment plan.
- Supplementation with higher doses of folic acid (4mg daily) is typically recommended before conception and during pregnancy for women taking Lamictal to help reduce neural tube defect risks.
- Regular monitoring of blood levels throughout pregnancy and dose adjustments are essential parts of prenatal care for women taking this medication 2, 3.
Monitoring and Dose Adjustments
- Blood samples should be collected every 1-3 months during pregnancy to maintain prepregnancy baseline drug levels 1.
- Lamotrigine's apparent and relative clearance increases across trimesters, particularly in the second and third trimesters, coinciding with a period of increased seizure frequency and required dose adjustments.
- Early interventions, such as empirical dose increases during pregnancy and postpartum tapering, and routine monitoring from preconception to the postpartum period may enhance seizure control, reducing the risk of breakthrough seizures for the mother and unborn child 1.