The 2023-2024 updates on teratovigilance, with a focus on antiseizure medications, highlight several key points. American medical societies have revised their recommendations: maintaining effective seizure control is essential for both maternal and fetal health; lamotrigine, levetiracetam, and oxcarbazepine are preferred first-line treatments, whereas valproic acid and topiramate should be avoided if possible. In March 2024, an update on topiramate indicated an increased risk of neurodevelopmental disorders with prenatal exposure. For autism spectrum disorders specifically, a recent study did not find evidence linking topiramate to autism spectrum disorder. Lastly, a potential risk of neurodevelopmental disorders in children with fathers who used valproic acid has been suggested, but remains unconfirmed.
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| http://dx.doi.org/10.53738/REVMED.2025.21.900-1.77 | DOI Listing |
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[Teratovigilance. Antiepileptics during pregnancy and paternal use].
Rev Med Suisse
January 2025
Swiss Teratogen Information Service, Service de pharmacologie clinique, Département de médecine, Centre hospitalier universitaire vaudois, 1011 Lausanne.
The 2023-2024 updates on teratovigilance, with a focus on antiseizure medications, highlight several key points. American medical societies have revised their recommendations: maintaining effective seizure control is essential for both maternal and fetal health; lamotrigine, levetiracetam, and oxcarbazepine are preferred first-line treatments, whereas valproic acid and topiramate should be avoided if possible. In March 2024, an update on topiramate indicated an increased risk of neurodevelopmental disorders with prenatal exposure.
View Article and Find Full Text PDFCarbapenems in the management of valproic acid overdose (MPT-01166-24 R1).
Br J Clin Pharmacol
January 2025
Departments of Medicine, Pediatrics, and Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Severe valproic acid (VPA) overdose is characterized by coma (sometimes with cerebral oedema), respiratory depression, hypotension and metabolic abnormalities. Traditional management of VPA poisoning has been limited to gastrointestinal decontamination, L-carnitine supplementation and, in severe cases, haemodialysis. Recently, interest has developed in the use of carbapenem antibiotics as an adjunctive therapy in patients with severe VPA poisoning.
View Article and Find Full Text PDFAntiseizure Medications in Poststroke Seizures: A Systematic Review and Network Meta-Analysis.
Neurology
February 2025
Department of Neurology, Yale University School of Medicine, New Haven, CT.
Background And Objectives: The most effective antiseizure medications (ASMs) for poststroke seizures (PSSs) remain unclear. We aimed to determine outcomes associated with ASMs in people with PSS.
Methods: We systematically searched electronic databases for studies on patients with PSS on ASMs.
Prenatal Valproic Acid Induces Autistic-Like Behaviors in Rats via Dopaminergic Modulation in Nigrostriatal and Mesocorticolimbic Pathways.
J Neurochem
January 2025
Department of Pathology, School of Veterinary Medicine, University of São Paulo, Sao Paulo, Brazil.
Autism spectrum disorder (ASD) is a complex developmental disorder characterized by several behavioral impairments, especially in socialization, communication, and the occurrence of stereotyped behaviors. In rats, prenatal exposure to valproic acid (VPA) induces autistic-like behaviors. Previous studies by our group have suggested that the autistic-like phenotype is possibly related to dopaminergic system modulation because tyrosine hydroxylase (TH) expression was affected.
View Article and Find Full Text PDFNeurological and Cognitive Effects of Hypothyroidism in Patients With Epilepsy: A Study on Anti-Seizure Medicines Therapy.
J Neurosci Res
January 2025
Department of Anaesthesiology and Intensive Care, Medical University Sofia, Sofia, Bulgaria.
The primary objective of this study was to examine neurological disorders and cognitive impairments in patients with secondary hypothyroidism and epilepsy undergoing treatment with antiepileptic medications. The study included 184 patients divided into three groups: Group 1 (subclinical hypothyroidism, n = 60), Group 2 (manifest hypothyroidism, n = 64), and Group 3 (control, n = 60). Patients in Group 2 received levothyroxine therapy (initial dose of 25 μg/day, titrated to 50-100 μg/day), while Groups 1 and 2 were treated with anti-seizure medications (valproic acid, 40 mg/kg/day).
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