Antiepileptika in der Stillzeit : Wie beraten wir die Mütter? [Use of antiepileptic drugs during breastfeeding : What do we tell the mother?]

Détails

ID Serval
serval:BIB_74DE51249317
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Antiepileptika in der Stillzeit : Wie beraten wir die Mütter? [Use of antiepileptic drugs during breastfeeding : What do we tell the mother?]
Périodique
Der Nervenarzt
Auteur(s)
Crettenand M., Rossetti A.O., Buclin T., Winterfeld U.
ISSN
1433-0407 (Electronic)
ISSN-L
0028-2804
Statut éditorial
Publié
Date de publication
08/2018
Peer-reviewed
Oui
Volume
89
Numéro
8
Pages
913-921
Langue
allemand
Notes
Publication types: English Abstract ; Journal Article
Publication Status: ppublish
Résumé
Knowledge about the passage of various antiepileptic drugs into breast milk and its consequences for the infant is limited. Faced with this uncertainty, breastfeeding is often discouraged for these patients. The aim of this study was to comprehensively review the available data regarding antiepileptic drugs during breastfeeding, to compare these data with information provided by the summary of product characteristics (SmPCs), and to provide recommendations for the use of these drugs in breastfeeding women.
We performed a systematic literature review on breastfeeding data for 23 antiepileptic drugs. A breastfeeding compatibility score was developed and validated. The estimated score based on the literature review was compared with the estimated score based on recommendations provided by the SmPCs.
We identified 75 articles containing exposure and safety data for 15 antiepileptic agents during breastfeeding. The comparison between the score values based on the literature review and on the SmPCs revealed a very low degree of concordance (weighted kappa: 0.08).
Phenobarbital, primidone, carbamazepine, valproate and levetiracetam are probably compatible with breastfeeding. Treatment with phenytoin, ethosuximide, clonazepam, oxcarbazepine, vigabatrin, topiramate, gabapentin, pregabalin, lamotrigine and zonisamide can be authorized during breastfeeding, provided breastfed infants are carefully monitored for side effects. Since data on the use of mesuximide, clobazam, rufinamide, felbamate, lacosamide, sultiame, perampanel and retigabine are insufficient to adequately assess the risk for breastfed infants, use in breastfeeding women is in principle not recommended and should be carefully evaluated on a case by case basis. In practice, a risk-benefit analysis should be performed for each mother under antiepileptic treatment wishing to breastfeed her child, so that individual risk factors can adequately be taken into account when counseling the patient.
Mots-clé
Antiepileptic drugs, Breastfeeding, Breastmilk, Epilepsy, Summary of product characteristics
Pubmed
Web of science
Création de la notice
03/03/2018 14:18
Dernière modification de la notice
05/10/2018 6:26
Données d'usage