This sheet is about exposure to lamotrigine in pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider.
What is lamotrigine?
Lamotrigine is a medication that is used to treat some types of epilepsy (medical condition that causes seizures). It is also used to treat bipolar disorder. A common brand name for lamotrigine is Lamictal®.
I take lamotrigine. Can it make it harder for me to get pregnant?
Having a seizure disorder, as well as long-term use of seizure medications, might be associated with irregular periods and hormonal disorders which could lead to a harder time getting pregnant (infertility). Many people have become pregnant while taking lamotrigine, but one study suggested this medication might make it harder for people who take it to get pregnant.
I just found out I am pregnant. Should I stop taking lamotrigine?
Talk with your healthcare providers before making any changes to how you take this medication. Having a seizure while pregnant could be harmful to a pregnancy. People who have bipolar disorder and stop taking their medication are at increased risk for episodes of depression or mania that may be harmful to both the person who is pregnant and the baby. For general information on depression in pregnancy, please see the MotherToBaby Depression fact sheet here: https://mothertobaby.org/fact-sheets/depression-pregnancy/. People with seizure disorders or psychiatric disorders who could become pregnant should discuss their options for treatment, including medications, with their healthcare providers before becoming pregnant when possible.
What else should I know about taking lamotrigine during pregnancy?
Lamotrigine is cleared from the body faster during pregnancy. This means that many people who are pregnant need to increase their dose of lamotrigine to keep the medication at the right level to work for them. Your healthcare provider can order blood tests to check the levels of medication. People who need to increase the dose of lamotrigine during pregnancy will also need to work with their healthcare providers after the baby is born to reduce their medication dose.
Does taking lamotrigine increase the chance for miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Studies have not found that lamotrigine is associated with a higher chance for miscarriage over the background risk.
Does taking lamotrigine increase the chance of birth defects?
Every pregnancy starts out with a 3-5% chance of having a birth defect. This is called the background risk. Several studies looking at several thousand pregnancies have found no increase in birth defects when lamotrigine is taken during pregnancy. One study suggested a less than 1% increase in oral clefts (the lip and/or roof of the baby’s mouth do not form correctly and need surgery to repair after birth), but this finding was not confirmed by other studies. The use of more than one seizure medication, in particular valproic acid along with lamotrigine, appears to be associated with an increased chance of birth defects.
Could taking lamotrigine cause other pregnancy complications?
Lamotrigine has not been associated with an increased chance for other pregnancy complications, such as preterm delivery (birth before week 37) or poor growth of the baby (small size, low birth weight, or head circumference).
I need to take lamotrigine throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth? There are not enough studies looking at this question to know if lamotrigine causes withdrawal.
Does taking lamotrigine in pregnancy affect future behavior or learning for the child?
Several studies have looked at the development of babies who were exposed to lamotrigine during pregnancy. Most of these studies did not find differences in behavior or learning between babies exposed to lamotrigine and those who were not.
Breastfeeding while taking lamotrigine:
Lamotrigine can get into breast milk. Lamotrigine then gets into the baby’s body if they are breastfeeding, often at levels that are similar to the parent’s levels. Most infants who are breastfed by someone taking lamotrigine are not expected to have side effects. However, there have been case reports of breastfed infants with breathing problems and anemia (low red blood cell counts). People who are taking lamotrigine and nursing their child can watch for possible side effects, such as trouble breathing, a rash, sleepiness, or poor sucking. If the baby develops a rash, or other symptoms, talk with your healthcare providers right away about if you should discontinue breastfeeding, as a rash could be a sign of toxicity. This is especially true for small, sick, or premature babies. If you notice anything unusual in your nursing infant, discuss the symptoms with your child’s healthcare provider. The product label for lamotrigine recommends that people use caution when using this medication during breastfeeding. However, the benefit of using lamotrigine may outweigh possible risks. Be sure to talk to your healthcare provider about your breastfeeding questions. If your lamotrigine dose was increased during pregnancy, work with your health care provider to lower it soon after delivery.
If a male takes lamotrigine could it affect fertility (ability to get partner pregnant) or increase the chance of birth defects? Studies have shown that men with seizure disorders or bipolar disorder may have lower fertility (make it harder for them to get their partner pregnant). Based on a small number of studies, lamotrigine does not seem to affect sperm counts, motility (movement of the sperm), or sex hormones in men. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet on Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
Please click here for references.
National Pregnancy Registry for Psychiatric Medications: There is a pregnancy registry for women who take psychiatric medications, such as lamotrigine. For more information you can look at their website: https://womensmentalhealth.org/research/pregnancyregistry/.
North American Antiepileptic Drug (AED) Pregnancy Registry: There is a pregnancy registry for women who take antiepileptic medications, such as lamotrigine. For more information you can look at their website: http://www.aedpregnancyregistry.org/.
OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.
