RISCHIO GENETICO ED EMBRIOTOSSICITA' DA FARMACI ANTIEPILETICI

Observations on chromosomal damages in cell cultured 'in vitro' and karyotypic abnormalities of lymphocytes 'in vivo' by phenytoin treatment as well as the cytogenetic abnormalities induced by clozapine are reported. The difficulties in ascertaining teratogenic effects of different antiepileptic drugs used in association for the treatment of epilepsy are also discussed. Clinical evidence, indicates that newborn of epileptic patients, treated with specific drugs during pregnancy, frequently are affected by congenital diseases of the then digestive and/or cardiovascular systems (Antiepileptic drugs children 'Fetal Hydantoin Syndrome'). Apparently phenytoin is most frequently responsible for congenital disease, such as: epicanthus hypertelorism, low set ears, palmar folds abnormalities, microcephaly etc. Though some authors disagree on the teratogenic effects of the antiepileptic drugs, to prevent malformations in the newborn it may be useful to avoid the treatment during pregnancy with association of antiepileptic drugs and to limit the use of these drugs to the minimum therapeutic amounts during day 20 and 40 of pregnancy.