Comedication with antidepressants poses no major teratogenic risk in women on AEDs
The use of antidepressant drugs in pregnant women taking antiepileptic drugs (AEDs) does not appear to contribute to a significant increase in the risk of congenital malformations, as well as affect seizure control, a study has found.
Researchers identified 2,081 women with epilepsy who had completed their pregnancies from the Australian Pregnancy Register of Antiepileptic Drugs in Pregnancy. Among 2,124 pregnancy outcomes analysed, 1,954 were exposed to AEDs in utero while the remaining 170 were unexposed.
In the group pregnant women with epilepsy treated with AED, comparisons were made among three exposure groups: pregnancy outcomes with first‐trimester exposure to antidepressants, outcomes with mothers diagnosed with depression and/or anxiety not treated with an antidepressant, and outcomes with mothers not diagnosed with depression and anxiety.
Fisher's exact test results showed no significant difference in the prevalence of malformations in infants who were additionally exposed to antidepressants vs those whose mothers had nonmedicated depression and/or anxiety vs those whose mothers had no such psychiatric conditions (10.2 percent vs 7.7 percent vs 6.9 percent, respectively; p=0.45). The prevalence rates in pregnancy outcomes unexposed to AEDs were also similar (p=0.27).
In mothers exposed to both AEDs and antidepressants during pregnancy, the frequencies of convulsive and nonconvulsive seizures throughout pregnancy were similar across comparative groups (p=0.78 and p=0.45, respectively).
Although limited by statistical power, the results suggest that that comedication with antidepressants and AEDs neither confers significant teratogenic risk nor negatively affects seizure control, researchers pointed out.
The present data should provide relevant information to clinicians who are managing epileptic pregnant women with depression and/or anxiety, for which an antidepressant may be indicated, they added. Nevertheless, additional studies are warranted to confirm the findings.