Study Finds Continued Use Of Risky Antiseizure Drugs During Pregnancy

Despite grounds of nan consequence of malformations astatine birth, aliases commencement defects, usage of immoderate antiseizure narcotics during gestation has persisted, according to a study published connected July 23, 2025, successful Neurology®, nan aesculapian diary of nan American Academy of Neurology. Use has besides accrued for narcotics wherever location is not capable grounds to cognize if they are safe during pregnancy. People pinch a debased level of resources had a disproportionately higher usage of these narcotics than group pinch a higher level of resources.

These medications tin beryllium utilized for epilepsy, temper disorders, chronic pain and migraine, which often hap astatine young ages, and sometimes group are taking them earlier they recognize that they are pregnant. The bully news is that usage of nan narcotics pinch nan top risks has decreased, and usage of nan safest narcotics has increased, but we are concerned to still spot usage during gestation of immoderate narcotics pinch known risks and caller narcotics pinch uncertain risk."

Rosemary Dray-Spira, MD, PhD, study author of nan French National Agency for nan Safety of Medicines and Health Products successful Saint-Denis

The study looked astatine broad information from a French nationalist gestation registry for accusation connected each pregnancies pinch vulnerability to astatine slightest 1 antiseizure medicine from 2013 to 2021. The narcotics were placed successful 3 information categories. The safest: lamotrigine and levetiracetam; those pinch uncertain risk, including pregabalin, gabapentin and newer narcotics specified arsenic lacosamide and zonisamide; and those pinch known risks, including valproic acid, valpromide, carbamazepine and topiramate.

A full of 55,801 pregnancies were exposed to astatine slightest 1 antiseizure medication.

Those exposed to nan safest narcotics accrued by 30% complete nan study.

Those exposed to valproic acerb and valpromide dramatically decreased owed to decreasing numbers of exposed pregnancies (down by much than 80%), accrued termination rates of exposed pregnancies and among those that ended successful childbirth, decreasing numbers of group having much than 1 30-day medicine filled for nan supplier aliases sustained vulnerability to nan supplier passim pregnancy.

Exposure to carbamazepine and topiramate hardly decreased complete nan study period.

Pregabalin and gabapentin became wide utilized during gestation during this time, resulting successful much newborns exposed (28% increase) and for pregabalin progressively pinch aggregate prescriptions and sustained vulnerability passim pregnancy.

Exposure to newer narcotics pinch uncertain risks besides accrued complete time.

Researchers besides divided nan participants into 3 groups based connected level of resources, which was defined by net and usage of a programme that helps screen wellness attraction costs that are not covered by basal wellness security for group pinch a debased income.

While mothers pinch debased resources accounted for astir one-fifth of pregnancies exposed to narcotics pinch either known risks aliases uncertain risks (18% and 19%, respectively), this proportionality was little among pregnancies exposed to nan safest narcotics (14%).

"These disparities could beryllium owed to various factors, including much predominant unplanned pregnancies and suboptimal attraction earlier conception aliases during gestation for group who are socioeconomically disadvantaged," Dray-Spira said. "More activity is needed to further trim vulnerability during gestation to these drugs, particularly among nan astir socially disadvantaged populations."

A limitation of nan study was that accusation astir vulnerability to nan narcotics was based connected claims, not connected existent usage of nan drugs.