Risk of Autism After Prenatal Exposure to Lamotrigine and Other Antiseizure Medications: Should Pregnant Women Be Concerned?

A recent study has prompted concerns regarding the potential development of autism spectrum disorder (ASD) in children who were exposed to specific seizure medications during their gestation.

The New England Journal of Medicine published the study, which examines the impact of topiramate, valproate, and lamotrigine on the cerebral development of infants exposed to these medications during pregnancy.

Risk of Autism after Prenatal Exposure to Lamotrigine and Other Antiseizure Medication — (Photo: Unsplash/Suhyeon Choi)

Study Overview and Key Findings

The study was headed by Dr. Sonia Hernández-Díaz and included data from two well-known U.S. healthcare databases covering 2000 to 2020. It particularly concerned children whose mothers had written prescriptions for seizure medications starting in the 19th week of pregnancy and continuing until their birth. The researchers observed how common ASD was in kids who were exposed to topiramate during the second half of pregnancy compared to kids who were not exposed to any seizure drugs.

The data showed that by age 8, 1.9% of children who had not been on antiseizure drugs had been diagnosed with ASD. More of these babies were born to women who had epilepsy: 4.2% had no exposure, 6.2% had topiramate exposure, 10.5% had valproate exposure, and 4.1% had lamotrigine exposure. For topiramate, the adjusted hazard ratio for ASD was 0.96; for valproate, it was 2.67; and for lamotrigine, it was 1.

What It Means for Women Who Are Pregnant

The study shows that doctors need to be very careful when giving seizure medicines to pregnant women. When other factors are taken into account, topiramate and lamotrigine do not significantly raise the risk of ASD.

However, valproate does significantly increase risk. This finding makes it clear that women who are pregnant should use caution while taking valproate.

Dr. Hernández-Díaz stressed how important it was to find a balance between the need to treat epilepsy in the mother and the possible risks to the growing baby. She said that alternatives like lamotrigine might be better for pregnant women who need to take antiseizure drugs. Healthcare professionals can use these results to make intelligent choices about how to treat pregnant women.

Related Studies on the Potential of Lamotrigine

A similar study from the Hector Institute for Translational Brain study in Germany found that lamotrigine might help ease the symptoms of ASD. Dr. Moritz Mall and associates claim that the drug may be able to restore brain cell functions that are broken because of changes in the MYT1L protein. This can help with ASD-related behavioral problems to be resolved. We have hope from this finding for future treatments that may deal with the hereditary problems that lead to ASD.

Lamotrigine, which is sold under the brand name Lamictal, is often used to treat seizures and keep bipolar disorder patients' moods stable. The drug was shown to undo changes in brain cells caused by DNA mutations. This suggests that it might be possible to treat ASD. The journal Molecular Psychiatry released these results, which show that people are still trying to find new ways to treat neurodevelopmental disorders.

These research findings highlight the need to provide pregnant women with seizures with specialist medical attention. While topiramate and lamotrigine appear safer, valproate is more prone to cause ASD in children. A good idea for women who are expecting is to talk to their doctors about the pros and cons of taking antiseizure drugs. This will protect both the mother's and the child's health and safety.