Antiepileptic Drugs Sometimes Used in Pregnancy

  • MJ Eadie
  • FJE Vajda


This chapter contains information concerning the dispositions of various antiepileptic drugs that have sometimes been used in pregnancy, in particular oxcarbazepine. The information concerning the effects of pregnancy on the pharmacokinetics of gabapentin, ethosuximide, vigabatrin, zonisamide and various benzodiazepines with antiepileptic properties is relatively scanty, though the available data do not suggest that there are significant departures from the principles set down in Chap.  3 in relation to the anticipated effects of pregnancy on drug disposition.


Antiepileptic Drug Clinical Pharmacokinetic Maternal Plasma Solid Dosage Form Antiepileptic Agent 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. André M, Boutroy MJ, Dubruc C et al (1986) Clonazepam pharmacokinetics and therapeutic efficacy in neonatal seizures. Eur J Clin Pharmacol 30:585–589CrossRefPubMedGoogle Scholar
  2. Challier JC, Rey E, Bintein T, Olive G (1992) Passage of S(+) and R(−) γ-vinyl-GABA across the human isolated perfused placenta. Br J Clin Pharmacol 34:139–143PubMedCentralCrossRefPubMedGoogle Scholar
  3. Christensen J, Sabers A, Sidenius P (2006) Oxcarbazepine concentrations during pregnancy: a retrospective study in patients with epilepsy. Neurology 67:1497–1499CrossRefPubMedGoogle Scholar
  4. Davanzo R, Bo SD, Bua J, Copertino M, Zanelli E (2013) Antiepileptic drugs and breastfeeding. Ital J Pediatr 39:50PubMedCentralCrossRefPubMedGoogle Scholar
  5. Eadie MJ, Tyrer JH, Smith GA, McKauge L (1977) Pharmacokinetics of drugs used for petit mal absence epilepsy. Clin Exp Neurol 14:172–183PubMedGoogle Scholar
  6. Eldon MA, Underwood BA, Randinitis EJ, Sedman AJ (1998) Gabapentin does not interact with a contraceptive regimen of norethindrone acetate and ethinyl estradiol. Neurology 50:1146–1148CrossRefPubMedGoogle Scholar
  7. Flesch G (2004) Overview of the clinical pharmacokinetics of oxcarbazepine. Clin Drug Invest 24:185–203CrossRefGoogle Scholar
  8. Frantzen E, Hansen JM, Hansen OE, Kristensen M (1967) Phenytoin (DilantinR) intoxication. Acta Neurol Scand 43:440–446CrossRefPubMedGoogle Scholar
  9. Kawada K, Itoh S, Kusaka T, Isobe K, Ishii M (2002) Pharmacokinetics of zonisamide in perinatal period. Brain Dev 24:95–97CrossRefPubMedGoogle Scholar
  10. Koup R, Rose JQ, Cohen ME (1978) Ethosuximide pharmacokinetics in a pregnant patient and her newborn. Epilepsia 19:535–539CrossRefPubMedGoogle Scholar
  11. Kuhnz W, Koch S, Jakob S, Hartmann A, Helge H, Nau H (1984) Ethosuximide in epileptic women during pregnancy and lactation period. Placental transfer, serum concentrations in nursed infants and clinical status. Br J Clin Pharmacol 18:671–677PubMedCentralCrossRefPubMedGoogle Scholar
  12. Mazzucchelli I, Onat FY, Ozaka C et al (2006) Changes in the disposition of oxcarbazepine and its metabolites during pregnancy and the puerperium. Epilepsia 47:504–509CrossRefPubMedGoogle Scholar
  13. Myllynen P, Pienimäki P, Jouppila P, Vähäkangas K (2001) Transplacental passage of oxcarbazepine and its metabolites in vivo. Epilepsia 42:1482–1485CrossRefPubMedGoogle Scholar
  14. Öhman I, Vitols S, Tomson T (2005) Pharmacokinetics of gabapentin during delivery, in the neonatal period, and lactation: does a fetal accumulation occur during pregnancy? Epilepsia 46:1621–1624CrossRefPubMedGoogle Scholar
  15. Oles KS, Bell WL (2008) Zonisamide concentrations during pregnancy. Ann Pharmacother 42:1139–1141CrossRefPubMedGoogle Scholar
  16. Pacifi GM, Taddeucci-Brunelli G, Rane A (1984) Clonazepam serum protein binding during development. Clin Pharmacol Ther 35:354–359CrossRefGoogle Scholar
  17. Patsalos PN, Berry DJ, Bourgeois BF et al (2008) Antiepileptic drugs - best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring, I.L.A.E. Commission on Therapeutic Strategies. Epilepsia 49:1239–1276CrossRefPubMedGoogle Scholar
  18. Petrenaite V, Sabers A, Hansen-Schwartz J (2009) Seizure deterioration in women treated with oxcarbazepine during pregnancy. Epilepsy Res 84:245–249CrossRefPubMedGoogle Scholar
  19. Pienimäki P, Lampela E, Hakkola J, Arvela P, Raunio H, Vähäkangas K (1997) Pharmacokinetics of oxcarbazepine and carbamazepine in human placenta. Epilepsia 38:309–316CrossRefPubMedGoogle Scholar
  20. Rane A, Tunell R (1981) Ethosuximide in human milk and in plasma of a mother and her nursed infant. Br J Clin Pharmacol 12:855–858PubMedCentralCrossRefPubMedGoogle Scholar
  21. Schmidt D, Elger CE (2004) What is the evidence that oxcarbazepine and carbamazepine are distinctly different antiepileptic drugs? Epilepsy Behav 55:627–635CrossRefGoogle Scholar
  22. Sills GJ, Brodie MJ (2007) Pharmacokinetics and drug interactions with zonisamide. Epilepsia 48:435–441CrossRefPubMedGoogle Scholar
  23. Striano P, Striano S (2008) Gabapentin: a Ca2+ channel α-2-δ ligand far beyond epilepsy. Drugs Today 44:353–368CrossRefPubMedGoogle Scholar
  24. Tomson T, Villén T (1994) Ethosuximide enantiomers in pregnancy and lactation. Ther Drug Monit 16:621–623CrossRefPubMedGoogle Scholar
  25. Tomson T, Lindbom U, Hasselström J (1990) Plasma concentrations of ethosuximide and clonazepam during pregnancy. J Epilepsy 3:91–95CrossRefGoogle Scholar
  26. Tran A, O’Mahoney T, Rey E, Mai J, Mumford JP, Olive G (1998) Vigabatrin: placental transfer in vivo and excretion into breast milk of the enantiomers. Br J Clin Pharmacol 45:409–411PubMedCentralCrossRefPubMedGoogle Scholar
  27. van Wieringen A, Vrijlandt CM (1983) Ethosuximide intoxication caused by interaction with isoniazid. Neurology 33:1227–1228CrossRefPubMedGoogle Scholar
  28. Wegner I, Edelsbroek P, de Haan G-J, Lindhout D, Sander JW (2010) Drug monitoring of lamotrigine and oxcarbazepine combinations during pregnancy. Epilepsia 51:2500–2502CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • MJ Eadie
    • 1
  • FJE Vajda
    • 2
  1. 1.Clinical Neurology and NeuropharmacologyUniversity of Queensland, and Honorary Consultant Neurologist, Royal Brisbane and Women’s HospitalBrisbaneAustralia
  2. 2.Department of Medicine and Neurology Director of the Australian Epilepsy and Pregnancy RegisterUniversity of Melbourne and Royal Melbourne HospitalMelbourneAustralia

Personalised recommendations