Oxcarbazepine feasible for pregnant women with substance use disorder

Use of oxcarbazepine (OXC) appears to be safe for the management of substance use disorder (SUD) with comorbid psychiatric symptomatology in nonepileptic pregnant mothers, according to a study.

“Published safety data in pregnant epileptic women suggest that OXC may be a treatment option in nonepileptic pregnant women with SUDs and psychiatric symptomatology,” the authors said.

A retrospective chart review was carried out to identify pregnant women aged ≥18 years with an SUD who delivered at the study site. Those with a current diagnosis of epilepsy/seizure disorder; concurrent use of lithium, anticonvulsants, medications with a Risk Evaluation and Mitigation Strategy programme or a black box warning for potential foetal toxicity; and multiparity were excluded.

Eligible patients were divided into two groups based on OXC exposure: 94 mother-neonate pairs in the OXC group and 194 pairs in the non-OXC group. Baseline characteristics differed in mean number of prior pregnancies (2.8 in the OXC group vs 2.2 in the non-OXC group; p=0.03).

No significant between-group differences were seen in emergent caesarean or maternal hyponatraemia. Average gestational age at OXC initiation was 19.8 weeks. There were no significant differences as well in the rates of prematurity, physical characteristics, malformation, and neonatal abstinence syndrome.

The results suggested that OXC may be considered for management of SUD with comorbid psychiatric symptomatology in nonepileptic pregnant women.

“Further studies should be conducted to determine statistical significance in larger sample sizes,” the authors said.