Evidence map›Paper›PMID 29487964›Full record

SynthesisDer Nervenarzt2018

[Use of antiepileptic drugs during breastfeeding : What do we tell the mother?]

M Crettenand, A O Rossetti, T Buclin, U Winterfeld

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Der Nervenarzt, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

M CrettenandFaculté de biologie et de médecine, Ecole de médecine, Université de Lausanne, Lausanne, Schweiz.
A O RossettiDépartement des Neurosciences Cliniques, Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne, Lausanne, Schweiz.
T BuclinSwiss Teratogen Information Service, Service de pharmacologie clinique, Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne, Lausanne, Schweiz.
U WinterfeldSwiss Teratogen Information Service, Service de pharmacologie clinique, Centre Hospitalier Universitaire Vaudois (CHUV), Université de Lausanne, Lausanne, Schweiz. ursula.winterfeld@chuv.ch.
University Hospital of Lausanne · CHUniversity of Lausanne · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKnowledge about the passage of various antiepileptic drugs into breast milk and its consequences for the infant is limited. Faced with this uncertainty, breastfeeding is often discouraged for these patients. The aim of this study was to comprehensively review the available data regarding antiepileptic drugs during breastfeeding, to compare these data with information provided by the summary of product characteristics (SmPCs), and to provide recommendations for the use of these drugs in breastfeeding women. MATERIAL AND

methodsWe performed a systematic literature review on breastfeeding data for 23 antiepileptic drugs. A breastfeeding compatibility score was developed and validated. The estimated score based on the literature review was compared with the estimated score based on recommendations provided by the SmPCs.

resultsWe identified 75 articles containing exposure and safety data for 15 antiepileptic agents during breastfeeding. The comparison between the score values based on the literature review and on the SmPCs revealed a very low degree of concordance (weighted kappa: 0.08).

conclusionPhenobarbital, primidone, carbamazepine, valproate and levetiracetam are probably compatible with breastfeeding. Treatment with phenytoin, ethosuximide, clonazepam, oxcarbazepine, vigabatrin, topiramate, gabapentin, pregabalin, lamotrigine and zonisamide can be authorized during breastfeeding, provided breastfed infants are carefully monitored for side effects. Since data on the use of mesuximide, clobazam, rufinamide, felbamate, lacosamide, sultiame, perampanel and retigabine are insufficient to adequately assess the risk for breastfed infants, use in breastfeeding women is in principle not recommended and should be carefully evaluated on a case by case basis. In practice, a risk-benefit analysis should be performed for each mother under antiepileptic treatment wishing to breastfeed her child, so that individual risk factors can adequately be taken into account when counseling the patient.

Indexed as

AnticonvulsantsBreast FeedingEpilepsyContraindications, DrugHumansRisk AssessmentAnticonvulsantsAntiepileptic drugsBreastfeedingBreastmilkEpilepsySummary of product characteristics

Identifiers

PMID29487964
OpenAlexW2794158492

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.