ArticleCNS neuroscience & therapeutics2022
Pharmacokinetic changes for newer antiepileptic drugs and seizure control during pregnancy.
Article in CNS neuroscience & therapeutics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- How is Levetiracetam Monotherapy Currently Monitored in Pregnancy? A Systematic Review.Clinical pharmacokinetics · 2026Pooled it
- Bayesian-Based Pharmacokinetic Framework Integrated with Therapeutic Drug Monitoring for Assessing Adherence to Antiseizure Medications: A Clinical Trial Simulation Study.Journal of medical Internet research · 2026Article
- Development and internal validation of a prognostic model for predicting tonic-clonic seizures during pregnancy in women with epilepsy.BMC pregnancy and childbirth · 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
- Application of Physiologically Based Pharmacokinetic Modeling to Predict Maternal Pharmacokinetics and Fetal Exposure to Oxcarbazepine.Pharmaceutics · 2022Article
- Pharmacokinetic changes for newer antiepileptic drugs and seizure control during pregnancy.CNS neuroscience & therapeutics · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate pharmacokinetic changes in newer antiepileptic drugs (AEDs) and assess seizure frequencies and risk factors of increased seizures during pregnancy in women with epilepsy (WWE).
methodsA total of 56 pregnancies in 53 WWE who received newer antiepileptic drugs (AEDs) were enrolled. Data on seizure activity and types, daily dose, and AEDs blood levels were derived from routine clinical follow-up. Changes in AEDs clearance were compared between each trimester and nonpregnant baseline. The ratio of AED levels of each trimester to their targets (nonpregnant baseline) concentrations (RTC) was compared between patients with and without an increased seizure. A binary logistic regression was used to investigate the risk factors contributing to seizure worsening during pregnancy.
resultsIncreased clearances of LTG, LEV, and OXC were observed in all trimesters versus nonpregnant baseline. The peak changes in the clearance of LTG (3.42-fold baseline clearance) (p < 0.001) and LEV (2.78-fold) (p < 0.001) occurred in the second trimester during pregnancy, followed by oxcarbazepine (2.11-fold) in the third trimester (p < 0.03). Plasma concentrations of LTG and LEV during pregnancy were significantly decreased compared to baseline levels, except for OXC. However, no significant differences in RTC values were observed between patients with and without seizure worsening. Some risk factors as seizures for the prior nine months could significantly affect seizure frequency during pregnancy.
conclusionWe found substantial changes in the pharmacokinetics of multiple newer AEDs in WWE, reinforcing the need for therapeutic drug monitoring (TDM) during pregnancy. We would encourage at least one monitoring every trimester and probably more frequently for women with poorly seizure control before pregnancy, and AEDs dose adjustment should keep up with clearance changes. In addition, a well-controlled seizure nine months before pregnancy could lower the risks of seizure during pregnancy, highlighting the importance of pre-pregnancy counseling and seizure management before pregnancy.
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