This sheet talks 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 with seizures). It is also used to treat psychiatric disorders. A common brand name for lamotrigine is LaMICtal®.
I have been taking lamotrigine for many years. Can this affect my ability to get pregnant?
Studies have found that the long-term use of seizure medications in women with a seizure disorder might be associated with irregular periods and difficulty getting pregnant (infertility). There are no studies on how lamotrigine might affect fertility.
I am taking lamotrigine. Should I stop taking my medication if I get pregnant?
Women should speak with their healthcare providers before making changes to this medication during pregnancy. Having a seizure while pregnant may be harmful to the pregnancy. Women with bipolar disorder or depression who stop taking medications during their pregnancy are at increased risk for episodes of depression or mania that may be harmful to both the mother and the baby.
Women with seizure disorders or psychiatric disorders who could become pregnant should discuss their options for treatment, including medications, with their healthcare provider before becoming pregnant.
Women should also discuss starting folic acid supplements with their health care provider prior to becoming pregnant. Folic acid is a B group vitamin. Because lamotrigine can affect the way the body uses folic acid your healthcare provider might discuss taking a higher than normal dose of folic acid for at least 1 month before trying to become pregnant and for the first 12 weeks of pregnancy.
Can taking lamotrigine during my pregnancy cause birth defects?
In every pregnancy, a woman starts out with a 3-5% chance of having a baby with a birth defect. This is called her background risk. Most studies find no increase in birth defects among women taking lamotrigine in the first trimester of their pregnancy. There have been several large studies (looking at several thousand pregnancies) that 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). 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.
However, it is important to remember that having a seizure or untreated psychiatric illness can be harmful to both mother and baby and therefore you should not stop or change your medication in pregnancy without speaking with your healthcare provider.
Could taking lamotrigine cause other pregnancy complications?
Studies have not found that lamotrigine is associated with other pregnancy complications such as preterm birth, or poor growth (such as small size, low birth weight, or head circumference).
Can taking lamotrigine during pregnancy affect my baby’s development after birth?
A number of studies examining the development of babies who were exposed to lamotrigine during pregnancy have found no major difference in development between babies exposed to lamotrigine and those who were not.
What else should I know about taking lamotrigine during pregnancy?
During pregnancy, women may need to increase their dose of lamotrigine in order to keep medicine levels at the right dose to work for them. Your health care provider can order blood tests while you are pregnant to check the levels of medicine in your body. Your dose of lamotrigine may need to be changed according to the results of these blood tests. If you need to increase your lamotrigine dose during pregnancy, the dose of lamotrigine will then need to be reduced after your baby is born to avoid the side effects of too high a dose.
Can I take lamotrigine while breastfeeding?
Lamotrigine can get into breast milk and then the baby’s body, likely at higher levels than with other seizure medication use while nursing. If you increased your lamotrigine dose in pregnancy, work with your healthcare provider to bring your dose down to proper levels for you. While the effect of lamotrigine in a nursing newborn is not clearly known, there are several reports of healthy nursing infants. There is a single report of breathing problems in a 16 day old baby whose mother was taking 850 mg/day of lamotrigine. However, most infants have no reported side effects. If you are taking lamotrigine you may choose to breastfeed your baby, but 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 healthcare provider right away.
What if the father of the baby takes lamotrigine?
There are no studies looking at effects on a pregnancy if a father takes lamotrigine. In general, exposures that fathers have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures and Pregnancy at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/pdf/.
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: www.massgeneral.org/aed/.