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Lamictal and Cleft Palate Dear Doctor Letter NEW PREGNANCY REGISTRY INFO Rate Topic: -----

#1 User is offline   ncc1701 

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Posted 11 August 2006 - 03:06 PM

Heya crazies,

I just got this Dear Healthcare Professional Letter:

(this is just a summary since I can't figure how to scan it in)

(Also I didn't know where to post this so move it if somewhere else makes more sense)

GSK and Health Canada would like to inform you of important new safety information concerning the antiepileptic, LAMICTAL ® (lamotrigine).

Emerging datea from the North American Antiepileptic Drug (NAAED) Pregnancy Registry suggest an association between lamotrigine and an increased risk of non-syndromic oral clefts over the reference population for the registry (ie. Active Malformations Surveillance Program at Brigham and Women's Hospital in Boston, USA).

Recently published data from the Registry report three cases of isolated, non-syndromic cleft palate and two cases of isolated, no-syndromic cleft lip without cleft palate in infants from 564 first-trimester lamotrigine monotherapy exposures, giving a rate of 8.9 per 1000, as compared to 0.37 per 1000 in the reference population for that registry.

The prevalence of oral clefts noted in the NAAED registry is also higher than the backgrround prevalence of non-syndromic oral clefts reported in the literature, including studies from the United States, Australia and Europe. While different studies have differing results due to geographic and case ascertainment variations, the reported range is 0.50 to 2.16 per 1000.

To assist with the assessment of risk, analysis of data from additional pregnancy registries, with approximately 2200 additional lamotrigine monotherapy first-trimester exposures has been conducted, and 4 additional non-syndromic cases of oral cleft have been identified. Follow-up information will be provided via the appropriate channels when available.

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Non-syndromic oral cleft refers to a kid having cleft lip +- cleft palate, with no other malformations.

Five cases in 564 pregnancies doesn't sound like much, and extrapolating this to the population is tricky. But it looks real on the face of it.

Something to add in to our already complicated risk-benefit anlysis anytime one of us thinks about pregnancy, MI, and drugs.

BTW.

Lamotrigine Pregnancy Registry: 1-800-336-2176
NAAED Pregnancy Registry: 1-888-233-2334
(that one's for all the antiepileptic drugs)

This post has been edited by ncc1701: 24 August 2006 - 09:46 AM

--ncc1701--

Dx: BPII with mixed episodes, GAD, agorophobia

Rx: Lamictal 300 @ 1830. Imovane 3.75 @hs prn. Seroquel 25 @hs.

"Dammit, Jim, I'm a doctor, not a psychiatrist!" (ST:TOS:The City on the Edge of Forever)

The Doctor sighed condescendingly. "I'd love to spout techno babble at you until you lapsed into comas, but I don't have the time." (ST:V)

#2 User is offline   LITTLELISA 

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Posted 08 January 2009 - 06:20 AM

i have only JUST started taking these and my 6 year old son was born with cleft palate and i was not even on meds then i dont think !!! .. so this obviously increases the risk for me i suppose ??? ..
omg !!!
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#3 User is offline   dianthus 

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Posted 08 January 2009 - 08:32 AM

Benzos have been thought to increase risk of cleft palate for years and there's data emerging that maybe they don't as much as was once thought.

I'd like to see broader evidence re: the Lamictal.
"And though I'd move my world to be with him, still the gap between us is too wide."



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