Earlier studies have determined that women who took topiramate during the early stages of their pregnancy for its anti-epileptic properties "had a two- to five-fold greater chance of giving birth to a baby with an oral cleft." However, these studies didn't observe women who took the drug at lower doses for non-seizure related purposes.
The latest study by researchers from Brigham and Women's Hospital and the Harvard T.H. Chan School of Public Health was based on nationwide Medicaid data concerning an estimated one million live births from 2000 to 2010. Corresponding author Sonia Hernandez-Diaz, M.D., DrPH, of the Harvard T.H. Chan School of Public Health, et al. studied the risk of oral clefts along with cleft palate or cleft lip in three groups: infants with mothers who took topiramate in their first trimester; infants born with mothers who took the drug lamotrigine (an unrelated drug used by patients with bipolar disorder and epilepsy); and infants who were never exposed to anti-epileptic medications in utero.
Results revealed that compared to either the lamotrigine or the unexposed group, the risk of oral clefts was at least three times higher for the topiramate group. At least one out of every 1,000 infants are born with an oral cleft. Meanwhile, among infants exposed to low doses of topiramate (median 100 milligrams [mg] daily dose) in the first trimester, the risk was increased to 2.1 out of every 1,000 live births. For women taking higher doses of topiramate (median 200mg daily dose), the risk was an alarming: 12.3 for every 1,000 live births (Related: Smoking During Pregnancy Increases Risk of Cleft Lip in Infants.)
Hernandez-Diaz comments, "Our results suggest that women with epilepsy on topiramate have the highest relative risk of giving birth to a baby with cleft lip or cleft palate, likely due to the higher doses of topiramate when used for controlling seizures." She concludes, "The best course may be to avoid prescribing high doses of topiramate to women of childbearing age unless the benefits clearly outweigh the risks."
If you have epilepsy and are looking for natural remedies, you can incorporate some of the herbs listed below into your diet:
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