Migraine Preventive Topamax May Cause Birth Defects

by Teri Robert, Lead Expert

A study published in the July 22, 2008, issue of Neurology®, indicates that taking the neuronal stabilizing agent (epilepsy drug) Topamax (topiramate) alone or along with other neuronal stabilizing agents during pregnancy may increase the risk of birth defects.

Research has shown that many medications of this type increase the risk of birth defects, but little research has been done on Topamax. Studies have shown that Topamax increases the risk of birth defects in animals. Maintaining effective epilepsy treatment during pregnancy is crucial because seizures may cause harm to the fetus.

For the study, researchers examined women who became pregnant while taking topiramate either on its own or along with other neuronal stabilizing agents. Of 178 babies born, 16 had major birth defects. Three of these were in infants whose mothers were taking only Topamax, and 13 were in those whose mothers were taking Topamax and other neuronal stabilizing agents.

Four of the babies had cleft palates or cleft lips, a rate 11 times higher than that expected if these women were not taking neuronal stabilizing agents. Four male babies had genital birth defects, with two of those classified as major defects, which is 14 times higher than the normal rate for this defect.

“More research needs to be done to confirm these results, especially since it was a small study,” said . “But these results should also get the attention of women with Migraine and their doctors, since topiramate is also used for preventing Migraine, which is an even more common condition that also occurs frequently in women of childbearing age.”2

John Craig, MRCP
the Royal Group of Hospitals
Belfast, Northern Ireland

Craig said the risk of birth defects may be different for women taking the drug for Migraine, but that the pregnancies of women exposed to topiramate should be monitored.

This study found that more birth defects occurred in women taking topiramate along with the drug valproate, or valproic acid, than in women taking topiramate and another neuronal stabilizing agents. Research has shown that valproate is associated with a high risk of birth defects.

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