Topiramate therapy of a mother during pregnancy may be associated with a risk of oral clefts in the offspring.
Use of topiramate:
(1) epilepsy
(2) migraine
(3) appetite suppression
(4) psychiatric disorders
Features:
(1) therapy with topiramate during the first trimester (OR 6.3 in Alsaad et al)
(2) higher dose of topiramate (OR > 100 mg per day was 5.2 in Hernandez-Diaz et al)
(3) oral cleft (cleft lip, palate defect)
(4) exclusion of other diagnosis that may explain an oral cleft
Other anomalies may involve:
(1) skeleton (limb or hand)
(2) heart
A woman taking topiramate may benefit from contraception. This may avoid therapy before a woman realizes that she is pregnant.
