1. For ethical reasons, it is not possible to do many kinds of research in a pregnant woman.
2. To identify risks that occur in a small proportion of those who take a medication during pregnancy, we need data on large numbers of pregnant women who were exposed.
One way that is being used to work on these problems is the creation of patient registries in which patients who are taking a medication during pregnancy can voluntarily register.
We, as prescribing mental health clinicians, should encourage all women who become pregnant while taking a mood stabilizer that is an antiepileptic to participate in registries for such patients. These registries also include pregnant women who take an antiepileptic medication for epilepsy or for pain.
For the United States and Canada, patients may be referred to the North American Antiepileptic Drug Pregnancy Registry (http://www.aedpregnancyregistry.org/), which is run by Harvard Medical School. The time commitment for participation is minimal.
Registries in other countries for women who become pregnant while taking an antiepileptic drug or take one during pregnancy include:
Eurap International Registry (eurapinternational.org)—for women in Europe, Asia, Oceania, Latin America, etc.
UK Epilepsy & Pregnancy Register (epilepsyandpregnancy.co.uk)—for women in the UK
Australian Pregnancy Register (epilepsy.org.au)—for women in Australia
Other pregnancy registries
The MGH Center for Women’s Mental Health maintains national pregnancy registries for psychiatric medications–atypical antipsychotics, antidepressants, and others (like stimulants and anxiolytics).
Cohen LS, Viguera AC, McInerney KA, Kwiatkowski MA, Murphy SK, Lemon EL, Hernández-Díaz S. Establishment of the National Pregnancy Registry for Atypical Antipsychotics. J Clin Psychiatry. 2015 Jul;76(7):986-9. doi: 10.4088/JCP.14br09418. PMID: 25939066.
Cunnington MC. The International Lamotrigine pregnancy registry update for the epilepsy foundation. Epilepsia. 2004 Nov;45(11):1468. doi: 10.1111/j.0013-9580.2004.451105.x. PMID: 15509254.
Freeman MP. Psychotropic medication use during pregnancy: changes to the labeling system and the importance of exposure registries. J Clin Psychiatry. 2015 Jul;76(7):990-1. doi: 10.4088/JCP.15ed10163. PMID: 26231008.
Holmes LB, Wyszynski DF. North American antiepileptic drug pregnancy registry. Epilepsia. 2004 Nov;45(11):1465. doi: 10.1111/j.0013-9580.2004.451102.x. PMID: 15509251.
Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E, Sabers A, Vajda F; Collaborative EURAP Study Group. EURAP: an international registry of antiepileptic drugs and pregnancy. Epilepsia. 2004 Nov;45(11):1463-4. doi: 10.1111/j.0013-9580.2004.451101.x. PMID: 15509250.
Vajda F, Lander C, O’brien T, Hitchcock A, Graham J, Solinas C, Eadie M, Cook M. Australian pregnancy registry of women taking antiepileptic drugs. Epilepsia. 2004 Nov;45(11):1466. doi: 10.1111/j.0013-9580.2004.451103.x. PMID: 15509252.
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