ArticleBrain and behavior2019
Pharmacokinetic changes and therapeutic drug monitoring of lamotrigine during pregnancy.
Article in Brain and behavior, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How is Levetiracetam Monotherapy Currently Monitored in Pregnancy? A Systematic Review.Clinical pharmacokinetics · 2026Pooled it
- Lamotrigine serum concentrations as longitudinal biomarkers for seizure risk prediction in pregnant women with epilepsy: a secondary analysis of the EMPiRE study.BMJ neurology open · 2026Article
- New Method for the Determination of Lamotrigine in Human Saliva Using SPE-LC-DAD.Molecules (Basel, Switzerland) · 2025Article
- Mechanisms of altered hepatic drug disposition during pregnancy: small molecules.Expert opinion on drug metabolism & toxicology · 2025Review
- Development of a PBPK Model for Lamotrigine which Incorporates Metabolism by UGT2B10: Impact of UGT2B10 Poor Metabolizer Phenotype and Pregnancy.The AAPS journal · 2025Article
- Monitoring levetiracetam concentration in saliva during pregnancy is stable and feasible.CNS neuroscience & therapeutics · 2024Article
- Association of oxcarbazepine concentration with seizure frequency in pregnant women with epilepsy.Epilepsy & behavior reports · 2024Article
- Management of Anti-Seizure Medications during Pregnancy: Advancements in The Past Decade.Pharmaceutics · 2022Review
- Pharmacokinetic changes for newer antiepileptic drugs and seizure control during pregnancy.CNS neuroscience & therapeutics · 2022Article
- Use of Phenytoin, Phenobarbital Carbamazepine, Levetiracetam Lamotrigine and Valproate in Pregnancy and Breastfeeding: Risk of Major Malformations, Dose-dependency, Monotherapy vs Polytherapy, Pharmacokinetics and Clinical Implications.Current neuropharmacology · 2021Review
- Article
- Affective disorders: A question of continuing treatment during pregnancy (Review).Experimental and therapeutic medicine · 2020Review
- Pharmacokinetic changes and therapeutic drug monitoring of lamotrigine during pregnancy.Brain and behavior · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate the pharmacokinetic changes in lamotrigine (LTG) from prepregnancy to postpartum and to assess the impact of therapeutic drug monitoring (TDM) on seizure management during pregnancy in a Chinese population.
methodsA series of women who were on LTG monotherapy before conception or during pregnancy were included in this retrospective study. The clinical characteristics of the mothers and fetuses were collected. The apparent clearance (AC) and the ratio to target concentration (RTC) were calculated for each trimester or for each month. RTCs were compared between patients with and without an increase in the frequency of seizures. A receiver operating characteristic curve to determine the RTC threshold, which predicts increased seizure frequency best, was drawn.
resultsA total of 12 patients and their 12 pregnancies were reviewed retrospectively. AC increased by 82.5% during the first trimester (p = 0.0343), 203.2% during the second trimester (p = 0.0010), and 197.0% during the third trimester (p = 0.0061) compared with the prepregnancy level. The value returned to the prepregnancy level after delivery. Seven patients who had adequate baseline information were included to examine the association between serum LTG concentration and seizure frequency. The RTC values of patients with and without an increased frequency of seizures were significantly different (p = 0.0164), and increased seizure frequency was associated with a lower RTC. An RTC < 0.64 was a predictor of deteriorating seizures.
conclusionsThe pharmacokinetic changes in LTG during pregnancy displayed marked interpatient variation. TDM can support a rational treatment plan for LTG use during pregnancy. We recommend regular monitoring of LTG serum concentrations from prepregnancy to postpartum.
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