Many Women Treated Off Label With Antiepilepsy Drugs.

Contributing Writer

NEW YORK -- Burgeoning numbers of women are being treated off label with antiepilepsy drugs for conditions such a migraine headache, bipolar disorder, and pain, and ob.gyns. need to be aware of thc drugs' adverse effects on reproductive health, Dr. Martha J. Morrell said at press briefing sponsored by the Epileps) Foundation.

"Antiepilepsy drugs and epilepsy itself are associated with infertility and reproductive health disorders, such as polycystic ovarian syndrome, and affect sexuality in significant ways. Antiepilepsy drugs (AEDs) can also render oral contraceptives ineffective and are more strongly associated with birth defects than any other class of drugs," said Dr. Morrell of the Columbia Comprehensive Epilepsy Center at New York-Presbyterian Hospital, New York, and past chair of the Epilepsy Foundation.

The list of problems associated with AEDs extends beyond reproductive and sexuality issues and includes weight gain, unwelcome changes in facial and body hair, gum swelling, and acne.

The Epilepsy Foundation says that although there are an estimated 1 million women in the United States with epilepsy, the number of women being treated with AEDs is two to three times higher than the total number with epilepsy

* Pregnancy. AED use during pregnancy is associated with birth defects. "In a recent study in The New England Journal of Medicine, 23% of children born to mothers who were taking antiepileptic drugs had some kind of birth defect, either a major malformation or a minor anomaly, and this is associated with the use of the older agents," she said. One of the older agents, phenobarbital, has a 25% rate of related birth defects, according to new data from the North American Antiepileptic Drug Pregnancy Registry

"This is not the drug of choice to use during pregnancy," Dr. Morrell said.