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Risks of Anticonvulsants During Pregnancy

If you’re a woman who takes anticonvulsants and are of childbearing age, take note. The Epilepsy Foundation warns that anticonvulsants could cause damage to a developing fetus very early in a pregnancy. Since about 50% of pregnancies in the US are unplanned and some anticonvulsants can reduce the effectiveness of hormonal birth control, this important news even if you don’t plan to get pregnant.

Some of the foundation’s pregnancy-related recommendations include:

  1. Talk with your health care provider about specific risks and benefits of anticonvulsants, both short- and long-term.
  2. If you are planning a pregnancy or you are pregnant, talk with your health care provider as soon as possible.
  3. If you become pregnant, enroll in the North American Pregnancy Registry as soon as your pregnancy is confirmed.
  4. Make sure that your anticonvulsant blood levels are monitored during pregnancy, and that your dose is changed as needed to prevent worsening of migraines or headaches.
  5. Do not stop or reduce your medication for any reason without advice from your health care provider. (Stopping anticonvulsants abruptly can cause seizures or other neurological symptoms.)

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Lyrica Now Available to Patients

Pfizer announced today that Lyrica (pregabalin) is now available for doctors to prescribe to patients. The drug is indicated for use for neuropathic pain and seizures, but has also shown to improve patients’ sleep patterns. A successor to Neurontin (gabapentin), the two drugs act similarly in the body. Of course the chemical structure is slightly different (and beyond my understanding), but one obvious difference is that Lyrica is more potent, which makes it effective at lower doses. This in turn decreases the likelihood of side effects.

The FDA won’t let Pfizer mention this, but Lyrica, like Neurontin, is likely to be prescribed to headache patients off-label. And, based on a conversation with my headache specialist, it’s a potentially exciting new option for prevention.

Even with his endorsement, I’m a little skeptical. You see, the FDA has approved the manufacturing of gabapentin as a generic. Once the generic is available, sales of Neurontin, also a Pfizer drug, will drop. Lyrica could become to Neurontin like Clarinex is to Claritin.

It’s too soon to tell if Lyrica will be a significant new drug for headache patients or if it will another name-brand moneymaker. For all our sakes, I’ve got my fingers crossed for the first option.

Some interesting details about the drug are also available.