Given that serum Lamotrigine levels can fall significantly in pregnancy, is there a role for monitoring lamotrigine in pregnancy (in the background of uncertainty of therapeutic range). Or should the strategy be based on clinical assessment alone- i.e. that if a pregnant woman experiences recurrent seizures or an increase in seizures in pregnancy then the patient should be given a bigger dose of Lamotrigine, regardless of what the blood level is. Then, when she has given birth a woman who has had her Lamotrigine dose increased during pregnancy will need to revert to her usual non pregnant dose. If the second approach is adopted, what are the potential risks to the foetus (i.e. mother being controlled but with unknown lamotrigine levels).
I would be interested in any views of the relative merits of lamotrigine monitoring in pregnancy
Regards
Martin Myers
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