A study of the pattern of malformations in children of women treated with carbamazepine during pregnancy is reported from the Division of Dysmorphology, Department of Pediatrics, University of California-San Diego, La Jolla, CA. The authors evaluated eight infants identified retrospectively as having had prenatal exposure to carbamazepine, alone or in combination with other drugs except phenytoin. In addition, in a prospective study they documented the outcome of the pregnancies of 72 women who were concerned early in their pregnancies about the potential teratogenicity of carbamazepine. The pattern of malformation including minor craniofacial defects, fingernail hypoplasia and developmental delay identified in the eight children in the retrospective study was confirmed through the evaluation of 48 children born alive to the women in the prospective study. The incidence of craniofacial defects was 11%, fingernail hypoplasia 26% and developmental delay 20%. The pattern of malformation with carbamazepine was similar to that of fetal hydantoin syndrome, suggesting that the epoxide intermediate metabolite is the teratogenic agent rather than the drug itself. [1]
COMMENT. We can now add carbamazepine (Tegretol) to the list of anticonvulsants with teratogenic effects.
A new use for carbamazepine is described from the Department of Pediatrics, 1011 Lausanne Switzerland [2]. Hereditary dominant chorea in an 11½ year old girl and in her mother was treated successfully with carbamazepine, confirming the experience of some other authors that this drug may have an effect on various choreas in a lower dose than that required for an antiepileptic effect.