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Divi

RLS n pregnancy n YOPD

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I’m a 34 yo PD pt, diagnosed 6 yrs ago. Happy to share that finally I’m pregnant . I have stopped pramipexole n I’m on sinemet now but RLS has worsened. Neuro put me on clonazepam but not much relief. Any thoughts? Thank you!

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I would visit with the pharmacist on this one and check FDA labeling for pregnancy on all drugs....but keep in mind that not much is known.  Sinemet is felt by many experts to be the safest.  After you get out of the first and second trimesters some people will add other drugs in....

If you don't want to use an agonist some people use folic acid plus gabapentin later in the pregnancy but again, not enough data....

P.S> There is a tale that a bar of ivory soap under your bed pillow stops RLS (if that works it has no pregancy risk!).

Pregnancy outcomes following gabapentin use

Results of a prospective comparative cohort study
This article has been cited by other articles in PMC.
This article has been cited by systematic reviews in PubMed.

Abstract

Objectives:

Our objectives were to 1) determine whether first-trimester use of gabapentin is associated with an increased risk for major malformations; 2) examine rates of spontaneous abortions, therapeutic abortions, stillbirths, mean birth weight and gestational age at delivery; and 3) examine rates of poor neonatal adaptation syndrome following late pregnancy exposure.

Methods:

The study design was prospective. Women were included who initially contacted the services between 5 and 8 weeks with a comparison group of women exposed to nonteratogens, collected in a similar manner.

Results:

We have data on 223 pregnancy outcomes exposed to gabapentin and 223 unexposed pregnancies. The rates of major malformations were similar in both groups (p = 0.845). There was a higher rate of preterm births (p = 0.019) and low birth weight <2,500 g (p = 0.033) in the gabapentin group. Among infants who were exposed to gabapentin up until delivery, 23 of 61 (38%) were admitted to either the neonatal intensive care unit or special care nursery for observation and/or treatment, vs 6 of 201 (2.9%) live births in the comparison group (p < 0.001). There were 2 cases of possible poor neonatal adaptation syndrome in neonates exposed to gabapentin close to delivery, compared with none in the comparison group, although it must be noted that these infants were concomitantly exposed to other psychotropic drugs. Among the women who took gabapentin, the major indications were pain (n = 90; 43%) and epilepsy (n = 71; 34%); the remainder were for other indications, mostly psychiatric.

Conclusion:

Our results suggest that although this sample size is not large enough to make any definitive conclusions, and there was no comparator group treated with other antiepileptic drugs, gabapentin use in pregnancy does not appear to increase the risk for major malformations. This finding and the increased risk for low birth weight and preterm birth require further investigation.

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