We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

Major Birth Defects After Exposure to Newer-Generation Antiepileptic Drugs

Lisa Merry, RN, MSc(A); Kathryn L. Martin, MD; Tianyan Chen, MD
JAMA. 2011;306(8):826-827. doi:10.1001/jama.2011.1184.
Text Size: A A A
Published online


To the Editor: In their study on newer-generation antiepileptic drugs, Ms Mølgaard-Nielsen and Dr Hviid concluded that first trimester exposure to newer-generation antiepileptic drugs was not associated with an increased risk of major birth defects when compared with no exposure.1 A slightly different conclusion was stated in the final section of their article: “The use of lamotrigine and oxcarbazepine during the first trimester was not associated with moderate or greater risks of major birth defects like the older-generation antiepileptic drugs, but our study cannot exclude a minor excess in risk of major birth defects. . . . ” The authors acknowledged that they had an inadequate sample size to draw firm conclusions regarding the individual effects of topiramate, gabapentin, and levetiracetam. However, we believe the study was also underpowered to detect an increased risk in major birth defects overall and for lamotrigine and oxcarbazepine. Therefore, definitive conclusions about whether newer-generation antiepileptic drugs are associated with an increased risk of major birth defects seem difficult to make based on this study.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




August 24, 2011
Torbjörn Tomson, MD; Dina Battino, MD; Emilio Perucca, MD
JAMA. 2011;306(8):826-827. doi:10.1001/jama.2011.1185.
August 24, 2011
Anders Hviid, MSc, DrMedSci
JAMA. 2011;306(8):826-827. doi:10.1001/jama.2011.1186.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.