Still considered a new ASD, teratogenicity from lacosamide (LCM) exposure during pregnancy is unknown. LCM metabolism through several cytochrome P450 enzymes and minor glucuronidation metabolism in the liver may increase during pregnancy and theoretically lead to lower LCM levels during pregnancy and the risk of increased seizures. Our objective was to determine the impact of pregnancy on serum LCM levels in a series of women with epilepsy (WWE).

We identified seven pregnancies with exposure to LCM with at least one level drawn during pregnancy. Patient ages ranged from 18 to 38 years (mean 26.4 years) and total daily doses of LCM ranged from 200 to 600 mg/day. Two patients had increased dose adjustments in response to breakthrough seizures. Dose normalized concentrations (DNC) showed an overall decrease over time through each trimester (p = 0.002) and significantly lower during trimester 2 and 3 (p = 0.001 and p = 0.004, respectively) compared to pre-pregnancy levels. There were no significant changes in seizure frequency and none of the neonates had teratogenic findings at time of birth. We are the first to report a case series on the changes in LCM levels during pregnancy with significant decreased LCM DNC levels during the second and third trimesters in comparison to pre-pregnancy values.

仍然被认为是一种新的 ASD，怀孕期间拉科酰胺 (LCM) 暴露的致畸性尚不清楚。通过几种细胞色素 P450 酶的 LCM 代谢和肝脏中的少量葡萄糖醛酸化代谢可能会在怀孕期间增加，理论上会导致怀孕期间 LCM 水平降低和癫痫发作风险增加。我们的目标是确定怀孕对一系列癫痫妇女 (WWE) 的血清 LCM 水平的影响。

我们确定了 7 次暴露于 LCM 的妊娠，在妊娠期间至少绘制了一个水平。患者年龄范围为 18 至 38 岁（平均 26.4 岁），LCM 的每日总剂量范围为 200 至 600 毫克/天。两名患者针对突破性癫痫发作进行了剂量调整。剂量归一化浓度 (DNC) 显示随着时间的推移在每个孕期总体下降 ( p  = 0.002) 并且在孕期第 2 和第 3 期显着降低 ( p  = 0.001 和p = 0.004，分别）与孕前水平相比。癫痫发作频率没有显着变化，并且没有新生儿在出生时有致畸性发现。我们是第一个报告妊娠期间 LCM 水平变化的病例系列，与孕前值相比，妊娠中期和晚期 LCM DNC 水平显着降低。