This sheet is about exposure to lamotrigine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.
What is lamotrigine?
Lamotrigine is a medication that has been used to treat bipolar disorder, some types of seizures, and Lennox-Gastaut syndrome (a severe form of epilepsy). A brand name for lamotrigine is Lamictal®.
Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. If your lamotrigine dose increases during pregnancy, talk with your healthcare provider about how and when to lower your dose after delivery.
Having a seizure while pregnant could be harmful to a pregnancy. Women who have bipolar disorder and stop taking their medication are at increased chance for episodes of depression or mania that may be harmful to both the woman who is pregnant and the pregnancy. For more information on depression in pregnancy, please see the MotherToBaby fact sheet at: https://mothertobaby.org/fact-sheets/depression-pregnancy/.
I take lamotrigine. Can it make it harder for me to get pregnant?
One study suggested that lamotrigine might make it harder 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).
Does taking lamotrigine increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not found that lamotrigine is linked to a higher chance of miscarriage.
Does taking lamotrigine increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like lamotrigine, might increase the chance of birth defects in a pregnancy.
One study suggested a small (less than 1% [less than 1 in 100]) increased chance of oral clefts, such as cleft lip and/or cleft palate (an opening in the upper lip or the roof of the mouth), when lamotrigine was used during the first trimester of pregnancy. However, this finding was not confirmed by other studies. Overall, several studies involving thousands of pregnancies have found no increased chance of birth defects with lamotrigine use during pregnancy.
Does taking lamotrigine in pregnancy increase the chance of other pregnancy-related problems?
Use of lamotrigine in pregnancy has not been linked with an increased chance for other pregnancy-related problems such as preterm delivery (birth before week 37 of pregnancy), low birth weight (weighing less than 5 pounds, 8 ounces [2,500 grams] at birth).
Does taking lamotrigine in pregnancy affect future behavior or learning for the child?
Several studies have looked at the development of babies and children 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.
Breastfeeding while taking lamotrigine:
Lamotrigine passes into breast milk. The amount of lamotrigine in breast milk is usually much lower than the amount that would be given to a baby directly to control seizures. Most infants who are exposed to lamotrigine in breastmilk are not expected to have side effects. There have been case reports of breastfed infants with breathing problems and anemia (low red blood cell counts).
Babies can be watched for possible side effects, such as a rash, trouble breathing, sleepiness, or poor sucking. If the baby develops any symptoms, especially a rash, contact your healthcare provider and your child’s healthcare provider right away. They will talk with you about using lamotrigine and the best way to treat your condition while breastfeeding. If your lamotrigine dose was increased during pregnancy, talk with your healthcare provider about how and when to lower your dose after delivery. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a male takes lamotrigine, could it affect fertility or increase the chance of birth defects?
In a small number of studies, lamotrigine has not been shown to affect sperm counts, motility (movement of the sperm), or male sex hormones. Studies have shown that males with seizure disorders or bipolar disorder may have reduced fertility (ability to make healthy sperm). In general, exposures that fathers or sperm donors have are less likely 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/.
National Pregnancy Registry for Psychiatric Medications: There is a pregnancy registry for pregnant 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 pregnant women who take antiepileptic medications, such as lamotrigine. For more information you can look at their website: http://www.aedpregnancyregistry.org/.
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