July 3, 2019

Are Antidepressant Medications Safe for Pregnant Women With Epilepsy? The Signs Point to Yes

Commentary on the article, “The Use of Antidepressant Drugs in Pregnant Women With Epilepsy: A Study From the Australian Pregnancy Register”

Managing epilepsy well across all stages of life requires a focus that expands beyond just treatment of seizures.

One often cited barrier to treatment is physician’s fear that antidepressant medications may contribute to poor seizure control. For women with childbearing potential, there may be additional concern that psychotropic medication use could further increase the risk of adverse pregnancy outcomes. In fact, women with epilepsy have been shown to be less likely to take antidepressant medication during pregnancy than other women, including women with other chronic diseases.

This study by Sivathamboo et al is the first to specifically examine pregnancy outcomes related to pharmacologic treatment of depression in women with epilepsy.

The authors found no significant effect of antidepressant exposure on congenital malformation risk. However, the sample sizes were small with only 7 women with treated and 3 with untreated depression and anxiety. Limitations of the study include that the presence of depression and anxiety were based on self-report by the study participants.

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