In Utero Oxcarbazepine Exposure and Neonatal Abstinence Syndrome: Case Report and Brief Review of the Literature

Pharmacotherapy. 2017 Jul;37(7):e71-e75. doi: 10.1002/phar.1955. Epub 2017 Jul 2.

Abstract

Oxcarbazepine is a second-generation antiepileptic drug that is used to treat partial seizures. Although it has been increasingly used in pregnant women, its fetal safety has not been fully validated. We describe a 12-hour-old neonate who developed neonatal abstinence syndrome (NAS) after intrauterine exposure to oxcarbazepine. The neonate was born via cesarean section to a mother who took oxcarbazepine 300 mg/day for treatment of seizures throughout her pregnancy. Approximately 12 hours after birth, the infant developed paroxysmal jitter, which mainly presented as increased excitability, irritability, limb shaking, and increased muscle tone. These symptoms resolved by day 9 of life. Although NAS occurs most often after in utero exposure to opioids, exposure to other drugs during pregnancy may contribute to a small proportion of NAS cases. To our knowledge, this is the second case report of oxcarbazepine-induced NAS. Pregnant women with epilepsy should weigh the pros and cons of continuing oxcarbazepine during their pregnancy when they are prescribed this drug. For infants with in utero oxcarbazepine exposure, comprehensive assessments and examinations are necessary for screening oxcarbazepine-induced NAS.

Keywords: Oxcarbazepine; jitter; neonatal abstinence syndrome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / blood
  • Carbamazepine / adverse effects
  • Carbamazepine / analogs & derivatives*
  • Carbamazepine / blood
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Neonatal Abstinence Syndrome / blood
  • Neonatal Abstinence Syndrome / diagnosis*
  • Oxcarbazepine
  • Pregnancy
  • Prenatal Exposure Delayed Effects / blood
  • Prenatal Exposure Delayed Effects / chemically induced*
  • Prenatal Exposure Delayed Effects / diagnosis*

Substances

  • Anticonvulsants
  • Carbamazepine
  • Oxcarbazepine