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Epilepsy

If you're among the many women of childbearing age with epilepsy, you and your obstetrician will have some medical decisions to make. The crux of the dilemma is that anti-epileptic medications used to prevent seizures increase the risk of certain problems for your child. But not taking these drugs could result in more frequent and longer lasting seizures that could also harm an unborn infant.

Notify your doctor as soon as you know you are pregnant. But don’t make any decisions about your current therapy until you talk with your doctor or neurologist.

In general, women with epilepsy have twice the risk of giving birth to a baby with congenital anomalies as a woman who doesn't have epilepsy. But anti-epileptic medications account for only part of this increased risk.

The good news is your chances of having a healthy, normal baby are over 90%.

If you are considering pregnancy, consult your doctor or neurologist about your medications. It's possible you may not need to take anti-epileptic medications during pregnancy if you've been seizure-free for several years and have normal brain waves on an electroencephalogram (EEG).

If you do need medication, you may be able to reduce the risk of birth defects significantly by changing from a combination of two or more drugs to a single anticonvulsant, or by taking lower, more frequent doses of your medication. Ask your doctor about these possibilities. 

Of the most commonly used medications prescribed to control seizures, lamotrigine (Lamictal) appears to have the lowest risk of side effects. And levetiracetam (Keppra) likely has a lower risk of side effects compared to other anti-epileptic drugs.

The ones that you should definitely try to avoid are divalproex (Depakote) and valproic acid (Depakene). Again call your doctor right away if you realize you are pregnant and take one of these drugs. Don’t just stop it abruptly. If you are not pregnant now, but thinking about becoming pregnant, talk with your doctor about switching to a different anti-seizure medication.

Topiramate (Topamax) also appears to have a higher side effect risk compared to other anti-epileptics. So, similar advice applies.

Make sure you take a folic acid supplement. Ideally start it a few months before you decide you want to become pregnant. The usual dose prior to pregnancy is 400 micrograms of folic acid daily. That's the amount in most multiple vitamins. But check with your doctor. He or she may advise a higher dose.

If you're among the many women of childbearing age with epilepsy, you and your obstetrician will have some medical decisions to make. The crux of the dilemma is that anti-epileptic medications used to prevent seizures increase the risk of certain problems for your child. But not taking these drugs could result in more frequent and longer lasting seizures that could also harm an unborn infant.

 

 

 

 

 

 

 

 


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