Abstracts

Rationale: This paper describes possibly the earliest reported case of a successful pregnancy with tiagabine monotherapy, plus monitored tiagabine blood levels. Methods: A 32 year old female with complex partial seizures and secondarily generalized tonic clonic seizures (onset as teenager, idiopathic, left and right temporal foci) had been well-controlled and almost perfectly compliant on tiagabine monotherapy (20-24 mg per day) since mid-1993 (as part of an FDA approved phase 3 premarketing drug study) and had 10 seizures in 6.6 years. Prior to that she was having by history 4-7 seizures/ year on phenytoin alone. Results: From February to November 1999, during a planned pregnancy, she maintained tiagabine therapy at the same dose (22-24 mg/day). She was carefully monitored. She had seizures at weeks 8 and 10 after last menstrual period on 22 mg/ day; and one in second trimester on 24 mg /day (but forgot her medication). She gave birth to a healthy baby in November 1999 and has breast fed the baby. During lactation, it was necessary to lower the dose from 24 to 20 mg because of toxicity. Blood level monitoring was done. Discussion: Though a single case history, these results contribute particularly given the stringent control data before and during pregnancy and lactation, the sane dosage and the blood level comparisons.