A high-risk preventative for the baby during pregnancy

In France, 600,000 people have epilepsy. Very weak neurological disease, some patients benefit from treatment Antipileptic Which allows them to live properly. However, this treatment is not without side effects. The National Agency for the Safety of Medicines and Health Products (ANSM) specifically refers to topiramate. In fact, it is responsible for the nervous system of children exposed to it during pregnancy. Explanation.

Topiramate, a high-risk preventative during pregnancy

Worldwide, an estimated 60 million people suffer from some form of epilepsy. They are 600,000 in France, half of whom are under the age of 20. To reduce the incidence of epilepsy, patients can benefit through treatment Antipileptic. If they improve the quality of life of many patients, there is some presence risk for the unborn child during pregnancy.

This incident Topiramate. Indeed, ANSM recalls that this drug is teratogenic. This means that in the case of pregnancy, it puts you at a greater risk of deformities such as cracking of the baby’s lips and palate, damage to the genitals, or loss of brain size. This antiepileptic drug increases the risk of being distorted by 3.

Nervous disorders in children

ANSM renews its recommendations on this treatment Antipileptic Due to recent results published in the journal JAMA Neurology. In fact, this study focuses on neurodevelopmental risk in exposed children. In the womb Generally antiepileptics. For this, the researchers analyzed data from several Nordic registers. In total, they held 4.5 million mother-child pairs followed between 1996 and 2017. Of these, 24,825 children have been exposed In the womb At least one drug AntipilepticThen followed for 8 years.

Thus, this work reveals an increase in topiramate intake during pregnancy:

  • Risk of developing an autism spectrum disorder (multiplied by 2.77);
  • Risk of intellectual disability (multiplied by 3.46).

These risks are higher than in women with epilepsy who have not received treatment during their pregnancy.

ANSM has requested a European evaluation of these results. But, in the meantime, it encourages women of childbearing age or pregnant women to consider these data now when prescribing topiramate.

ANSM recommendation for women taking topiramate

Also, ANSM is taking advantage of this new data to repeat its recommendations for women taking topiramate.

In fact, if the woman is pregnant or suspects pregnancy and taking topiramate Antipileptic, It is essential to consult your doctor to assess the need to continue treatment. If taken as a treatment for migraine, it will probably stop in favor of another treatment.

Also, topiramate may reduce the effectiveness of the birth control pill. Thus, ANSM reminds that it is necessary to take a highly effective contraceptive under the recommendation of its doctor.

If you plan to become pregnant or breastfeed, the treatment will be adapted by a doctor. In any case, if taken as a topiramateAntipileptic, It should not be stopped without the advice of his doctor. Indeed, a sudden cessation can lead to a major resurgence of epilepsy that could endanger the life of the woman and her child.

Alexia F., Doctor of Neuroscience


– Association of antenatal exposure to antiseptic drugs, including the risk of autism and intellectual disability. jamanetwork.com. Accessed July 1, 2022.
– Topiramate: a risk of neurodevelopmental disorders in infants exposed to the uterus and a reminder of the rules of use in women. ansm.sante.fr Accessed July 1, 2022.

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