Neurodevelopment After In Utero Exposure to Phenytoin and Carbamazepine

Joseph S. Jeret, MD; Rockville Centre, NY
JAMA. 1994;272(11):850. doi:10.1001/jama.1994.03520110028017.
Text Size: A A A
Published online

To the Editor.  —The study by Dr Scolnik and colleagues1 has two important flaws. The authors acknowledge that "even when not exposed to medications, infants of mothers with epilepsy have higher rates of malformations than those in the general population." They then compare 36 patients taking carbamazepine, of whom only 30 (83%) were epileptic, with 34 patients taking phenytoin, of whom 33 (97%) were epileptic (χ2=3.7, P=.05). The epileptics receiving phenytoin are inherently more likely to bear malformed children.In addition, the mean maternal dose of phenytoin was 5.9 mg/kg per day and for carbamazepine 8.9 mg/kg per day. For a 60-kg woman, that translates to a daily dose of 354 mg of phenytoin and 534 mg of carbamazepine. The Physicians' Desk Reference2 lists the average adult maintenance doses for phenytoin as 300 to 400 mg per day and for carbamazepine as 800 to 1200 mg


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview




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.
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.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


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

Sign In to Access Full Content

Related Content

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