To the Editor.—
Dr Stenchever's answer to the questions about seizure disorders and pregnancy1 nicely touches almost all aspects that must be considered. However, the inclusive statement about all anticonvulsive agents offering potential danger to the fetus seems a bit misleading. The discussion is directed toward birth defects. Of course, any drug offers the potential for danger to the fetus; however, carbamazepine has not been known to be associated with fetal defects.2,3 While one study showed a correlation between carbamazepine use and lower—birth weight infants, no deformities have been noted.4This is not to suggest that the patient be changed from therapy with one drug to use of another, because, as Dr Stenchever suggests, it is imprudent to alter therapy in a patient whose condition has been controlled by current therapy for an unproved, even questionable, advantage. Yet, carbamazepine has been shown to be as effective as
Butler CD. Carbamazepine, Seizure Disorders, and Pregnancy. JAMA. 1983;250(23):3164. doi:10.1001/jama.1983.03340230022020
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