Safely Taking Lamictal While Pregnant or Breastfeeding

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Is Lamictal safe during pregnancy? Is it, or the generic lamotrigine, safe during breastfeeding? Does Lamictal cause birth defects? While there is not enough data to answer these questions conclusively, researchers have been able to gather enough information to issue guidelines.

During Pregnancy

Thus far, Lamictal has not been shown to cause any significant increases in birth defects overall. Some data shows that there is an increased risk of cleft lip and palate malformations, but other data does not.

The FDA-approved prescribing information says that lamotrigine "should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus." The "potential benefit" is generally the mother's mental health condition.

In a 2009 article, Dr. Ruta M. Nonacs points out that many women with bipolar disorder may require a mood stabilizer during pregnancy. The alternatives to Lamictal, she says, may carry even greater risks. Depakote, for example, carries a 10% risk of birth defects, some very serious, and Topamax carries a strong warning about the risk of cleft lip and palate malformations. Tegretol (carbamazepine), Trileptal (oxcarbazepine) and Lithium are also classed as being more likely than Lamictal to be dangerous to a fetus. Anti-epileptic drugs in the same pregnancy class as Lamictal are:

  • Keppra (levetiracetam)
  • Gabitril (tiagabine)
  • Neurontin (gabapentin)
  • Topamax (topiramate)

While Breastfeeding

Lamictal does pass into breast milk, and the prescribing information says breastfeeding while taking Lamictal or lamotrigine (in any form) is not recommended. However, reports of breastfed infants whose mothers are taking lamotrigine having problems are uncommon.

If you do choose to breastfeed your infant while taking Lamictal, your infant should be closely monitored for side effects such as interrupted breathing, rash, drowsiness or poor sucking. If any infant rash occurs, breastfeeding should be discontinued until the cause can be established. This is because Lamictal is associated with dangerous rashes. Have the infant's rash evaluated promptly.

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  1. Pariente G, Leibson T, Shulman T, Adams-Webber T, Barzilay E, Nulman I. Pregnancy outcomes following in utero exposure to lamotrigine: A systematic review and meta-analysis. CNS Drugs. 2017;31(6):439–450. doi:10.1007/s40263-017-0433-0

  2. Dolk H, Wang H, Loane M, et al. Lamotrigine use in pregnancy and risk of orofacial cleft and other congenital anomaliesNeurology. 2016;86(18):1716–1725. doi:10.1212/WNL.0000000000002540

  3. Massachusetts General Hospital Center for Women's Mental Health. Lamotrigine and Pregnancy: An Update. Updated August 2009.

  4. Grover S, Avasthi A. Mood stabilizers in pregnancy and lactationIndian J Psychiatry. 2015;57(Suppl 2):S308–S323. doi:10.4103/0019-5545.161498

  5. Gedzelman E, Meador KJ. Antiepileptic drugs in women with epilepsy during pregnancy. Ther Adv Drug Saf. 2012;3(2):71–87. doi:10.1177/2042098611433192

  6. U.S. Food & Drug Administration. Highlights of prescribing information. Lamictal (lamotrigine) tablets. Updated May 2009.  

  7. Drugs and Lactation Database (LactMed). Lamotrigine. Bethesda, MD: National Library of Medicine; 2020.

Additional Reading
  • FDA-Approved Label for Lamictal published October 12, 2010.

  • Lamotrigine - Brands, Medical Use, Clinical Data. DrugLib.com.

  • Lamotrigine in pregnancy and breastfeeding. Drug Safety Society.

  • Lamotrigine use while Breastfeeding. Drugs.com.

  • Cunnington, M., Ph.D., Tennis, P., MD, and the International Lamotrigine Pregnancy Registry Scientific Advisory Committee. Lamotrigine and the risk of malformations in pregnancy. Neurology March 22, 2005, vol. 64 no. 6 955-960.
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