Risks of Fetal Exposure to Topiramate

Antiseizure medications are commonly used in persons of childbearing potential for multiple indications (e.g., epilepsy, pain, and psychiatric disorders). All antiseizure medications are potential teratogens that could cause congenital malformations and cognitive or behavioral impairments.(1) However, these effects vary markedly across antiseizure medications. For example, fetal exposure to valproate has been repeatedly associated with neuropsychological impairments, whereas many studies have shown no such association with fetal exposure to lamotrigine.(2) A recent large, population-based study involving five Nordic countries showed an association between fetal exposure to topiramate and the risk of autism spectrum disorder.(3) Among children born to mothers with epilepsy, . . .