PREGNANCY-BIRTH Messages for September, 2003: Re: Need advice about tegretol/folic acid requirements//For Dr. Chudacoff

Re: Need advice about tegretol/folic acid requirements//For Dr. Chudacoff

From: Marie (anonymous@obgyn.net)
Mon, 22 Sep 2003 19:30:50 -0500 (CDT)

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In reply to: Richard Chudacoff, MD: "Re: Need advice about tegretol/folic acid requirements"

At Mon, 22 Sep 2003, anonymous wrote: Dear Anonymous... I just wanted to let you know that I also take Tegretol XR, 200mg 2X/day(relatively small dose).I do have 2perfectly healthy, beautiful children. I feel truly blessed. I did try to go off of my medicine, but had a seizure I have had 3seizures in 13years, triggered by lack of sleep-none while on Tegretol).I went back on Tegretol and got pregnant 1 month later. You should see a perinatologist, either as your normal OB or they will send you for a consult with a peri at 18-weeks. The latter is what I did because I really like my OB. Anyway, once you have your mid-pregnancy sonogram, and, assuming everything is o.k., I think you can enjoy it as anyone else would. It is nerve-racking; however, if you aren't healthy, your baby CAN'T be.

Prior to and during the first 4months of pregnancy I take 1000 mcg of Folic Acid 3X/day as per my neurologist. Remember, a person not taking tegretol has a 2-3%chance of birth defects, 50%of which are major, 50% of which are minor. A person taking Tegretol has 4-6%, which is double. BUT you still have at least a 95%chance of a perfectly normal baby.

People like you and I have very special situations which must be monitored (i.e.regular Tegretol levels, because as your blood volume increases with pregnancy the concentration of drug decreases, which can be very bad). You can do this, and I wish you luck.

At Mon, 22 Sep 2003, Richard Chudacoff, MD wrote: I like this response better than Marie's

-- Richard Chudacoff, MD, FACOG Chudacoff Obstetrics & Gynecology, PLLC Sugar Land, TX

Note: opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

Dear Dr. Chudacoff, I also like this response better than mine and wish it were true that having a perfectly normal baby were "at least 95%" while taking Tegretol, this doesn't even take into account the average age related rates of early pregnancy loss, or risks to both mother and child related to thyroid dysfunction or bleeding/clotting disorders, SLE etc. that may arise with Tegretol.

--
As a neuroscientist I tried to look at all contingencies, including the latest
recommendations for folate supplementation etc. Icited 4-5mg p/day the poster
cited 3mg p/day this is close.  As a person who has taken Tegretol and allergic
having(Stevens Johnson Syndrome/TENS adverse reactions),am well aware that numerous
unexpected crossreactions that may occur during pregnancy.  The last time I took
Tegretol was over 2yearsago, and at least 1year since any reactions.  To my great
surprise in addition to missing my period, I started having non-turmatic purpura,
skin slipage etc all signs of reaction to Tegretol, it was the HCG, the antibodies
can't tell the difference between HCG and Tegretol. Pregnancy on Tegretol is high
risk, it can be successful with due caution.
Marie

Next message: Confused: "Do i need to re-test again ???????? I need your advice please"
Previous message: Marie: "Re: Dr. or Nurse Please... Early Ultrasound Findings :)"
In reply to: Richard Chudacoff, MD: "Re: Need advice about tegretol/folic acid requirements"

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