Čes. slov. farm. 2010, 59(4):172-178

Development of a treatment of pregnant women suffering from epilepsy in the region of Ostrava between the years 1991 and 2006

I. Kacířová^*, M. Grundmann, B. Kořístková, H. Brozmanová

Department of Clinical Pharmacology, Medical Faculty, University Ostrava and University Hospital, Ostrava

The paper discusses long-term trends in the utilization of antiepileptic drugs during pregnancy and reports an analysis of their concentrations at delivery. The request forms for routine therapeutic drug monitoring and concentrations of antiepileptic drugs at delivery collected between the years 1991-2006 were used as the data source. Monotherapy versus polytherapy, the utilization of individual antiepileptic drugs and combinations, and concentrations were monitored in a group of 235 pregnancies within three 5-year periods. Monotherapy was used in 61% in the years 1991-1995, in 68% in the years 1996-2000, and in 76% in the years 2001-2006. During the1^st period, the most frequently prescribed agents were phenytoin, carbamazepine and primidone, during the 2^nd period, carbamazepine, phenytoin, and valproic acid, and during the 3^rd period, carbamazepine, lamotrigine, and valproic acid. Concentrations were mostly under the therapeutics range with an exception of carbamazepine and primidone. Our data demonstrate a significant shift from poly- to monotherapy and from the first- and second-generation to the second- and third-generation of antiepileptic drugs in pregnant women suffering from epilepsy. The shift from poly- to monotherapy has taken place 10 years later and, moreover, the rate of monotherapy was lower than in Sweden but the result was in a good agreement with the EURAP report. Our results evidence a good progress in the treatment of pregnant women suffering from epilepsy in the region of Ostrava.

Keywords: pregnancy; epilepsy; antiepileptic drugs; therapeutic drug monitoring

Received: May 28, 2010; Accepted: July 14, 2010; Published: April 1, 2010  Show citation