PHENSUXIMIDE

Fetal Risk Summary

The use of phensuximide, the first succinimide anticonvulsant used in the treatment of petit mal epilepsy, has been reported in three pregnancies (1,2). Because of multiple drug therapy and difference in study methodology, conclusions linking the use of phensuximide with congenital defects are difficult. Fetal abnormalities identified with the three pregnancies include ambiguous genitalia, inguinal hernia, and pyloric stenosis. Phensuximide has a much lower teratogenic potential than the oxazolidinedione class of anticonvulsants (see Trimethadione) (3,4). Because of a high incidence of toxic effects, the new succinimides should be considered in favor of phensuximide for the treatment of petit mal epilepsy (see Ethosuximide, Methsuximide) (5).

Breast Feeding Summary

No data are available.

References

1. Fedrick J. Epilepsy and pregnancy: A report from the Oxford Record Linkage Study. Br Med J 1973;2:442–8.
2. McMullin GP. Teratogenic effects of anticonvulsants. Br Med J 1971;2:430.
3. Fabro S, Brown NA. Teratogenic potential of anticonvulsants. New Engl J Med 1979;300:1280–1.
4. The National Institutes of Health. Anticonvulsants found to have teratogenic potential. JAMA 1981;241:36.
5. Schmidt RP, Wilder BJ. Epilepsy. In Contemporary Neurology Series, No. 2. Philadelphia, PA: FA Davis, 1968;159.