拉莫三嗪个体化治疗妊娠期癫痫的必要性及思考

The Necessity and Thinking of Individual Treatment with Lamotrigine for Epilepsy During Pregnancy

拉莫三嗪是治疗妊娠期癫痫的首选药物之一,但其在妊娠期的药代动力学个体差异很大,影响因素及确切机制尚不完全清楚,可能因用量过大对胎儿造成危害或用量不足造成癫痫控制不佳,因此,妊娠期实现拉莫三嗪的个体化治疗尤为重要。本文将分别阐述拉莫三嗪在妊娠期和产后浓度变化的影响因素以及拉莫三嗪对胎儿的安全性影响,了解拉莫三嗪在妊娠期癫痫患者中的变化特点,并提出群体模型研究,有望为拉莫三嗪妊娠期癫痫的个体化治疗提供解决方案。

Lamotrigine is one of the first drugs for the treatment of epilepsy during pregnancy,but its pharmacokinetics during pregnancy varies greatly.The influencing factors and the exact mechanism are not fully understood.It may cause harm to the fetus due to excessive dosage,or poor control of epilepsy due to insufficient dosage,so individualized treatment of lamotrigine during pregnancy is particularly important.The factors influencing the changes of lamotrigine concentration during pregnancy and postpartum,and the effect of lamotrigine on the safety of the fetus will be discussed in the article,so as to describe the changes of lamotrigine during pregnancy,and propose that the population model study is expected to provide solutions for individualized treatment of lamotrigine in the treatment of pregnancy epilepsy.