This sheet is about exposure to lamotrigine in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is lamotrigine?
Lamotrigine is a medication that is used to treat some types of epilepsy (medical condition that causes seizures). It is also used to treat psychiatric disorders, such as bipolar disorder. A common brand name for lamotrigine is Lamictal®.
I take lamotrigine. Can it make it harder for me to get pregnant?
Having a seizure disorder, as well as long-term use of seizure medications, might be associated with irregular periods and hormonal disorders which could lead to a harder time getting pregnant (infertility). Many people have become pregnant while taking lamotrigine, but one study suggested this medication might make it harder for people who take it to get pregnant.
I just found out I am pregnant. Should I stop taking lamotrigine?
Talk with your healthcare providers before making any changes to how you take this medication. Having a seizure while pregnant could be harmful to a pregnancy. People who have bipolar disorder or depression and stop taking their medication are at increased risk for episodes of depression or mania that may be harmful to both the person who is pregnant and the baby. People with seizure disorders or psychiatric disorders and who could become pregnant should discuss their options for treatment, including medications, with their healthcare providers before becoming pregnant.
What else should I know about taking lamotrigine during pregnancy?
Lamotrigine is cleared from the body faster during pregnancy. Many people who are pregnant need to increase their dose of lamotrigine to keep the medication at the right level to work for them. Your healthcare provider can order blood tests to check the levels of medication. People who need to increase the dose of lamotrigine during pregnancy will need to work with their healthcare providers after the baby is born to reduce their medication dose.
Does taking lamotrigine increase the chance for miscarriage?
Miscarriage can occur in any pregnancy. Studies have not found that lamotrigine is associated with a higher chance for miscarriage over the background risk.
Does taking lamotrigine increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Several studies looking at several thousand pregnancies have found no increase in birth defects. One study suggested a less than 1% increase in oral clefts (the lip and/or roof of the mouth do not form correctly and need surgery to repair after birth), but this finding was not confirmed by other studies. The use of more than one seizure medication, in particular valproic acid, along with lamotrigine, appears to be associated with an increased chance of birth defects.
Could taking lamotrigine cause other pregnancy complications?
Lamotrigine has not been associated with other pregnancy complications, such as preterm delivery (delivery before week 37) or poor growth (small size, low birth weight, or head circumference).
I need to take lamotrigine throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?
Based on one study, lamotrigine use in pregnancy is not expected to cause withdrawal symptoms in baby after birth.
Does taking lamotrigine in pregnancy cause long-term problems in behavior or learning for the baby?
Several studies have looked at the development of babies who were exposed to lamotrigine during pregnancy. Most of these studies did not find differences in behavior or learning between babies exposed to lamotrigine and those who were not.
Can I breastfeed while taking lamotrigine?
Lamotrigine can get into breast milk and then the baby’s body, often at levels that are similar to the parent. The possible effects of lamotrigine in a nursing newborn are not clearly known, but no side effects have been reported in most infants. There have been case reports of breastfed infants with breathing problems and anemia (low red blood cell counts). People who are taking lamotrigine and nursing their child can watch for possible side effects, such as a rash, sleepiness, or poor sucking. This is especially true for small, sick, or premature babies. If you notice anything unusual in your nursing infant, discuss the symptoms with your child’s healthcare provider. The product label for lamotrigine recommends that people use caution when using this medication during breastfeeding. However, the benefit of using lamotrigine may outweigh possible risks. Be sure to talk to your healthcare provider about your breastfeeding questions.
I take lamotrigine. Can it make it harder for me to get my partner pregnant or increase the chance of birth defects?
Studies have shown that men with seizure disorders as well as psychiatric disorders, such as bipolar disorder, may have lower fertility (make it harder for them to get their partner pregnant). Based on a small number of studies, lamotrigine does not seem to affect sperm counts, motility, or sex hormones in men. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
Please click here for references.
National Pregnancy Registry for Psychiatric Medications: There is a pregnancy registry for women who take psychiatric medications, such as lamotrigine. For more information you can look at their website: https://womensmentalhealth.org/research/pregnancyregistry/.
North American Antiepileptic Drug (AED) Pregnancy Registry: There is a pregnancy registry for women who take antiepileptic medications, such as lamotrigine. For more information you can look at their website: http://www.aedpregnancyregistry.org/.