Maternal Lamotrigine Treatment and Elevated Neonatal Gamma-Glutamyl Transpeptidase

Lamotrigine is an antiepileptic drug with a low adverse-effect profile. This report describes an infant born to an epileptic mother treated with lamotrigine, who had a highly elevated gamma-glutamyl transpeptidase level after birth. There was no other clinical or biochemical evidence of liver or bile duct dysfunction. Infant serum level of lamotrigine, which crosses the placenta, was within therapeutic limits. Gamma-glutamyl transpeptidase levels declined slowly during the following months. We suggest that, in the absence of additional markers of tissue damage, the infant's gamma-glutamyl transpeptidase elevation was caused by maternal intake of lamotrigine. Liver function tests should be monitored in infants of lamotrigine treated mothers, as enzyme elevation might still suggest liver damage.