Medicine
Fact-checked

At WiseGEEK, we're committed to delivering accurate, trustworthy information. Our expert-authored content is rigorously fact-checked and sourced from credible authorities. Discover how we uphold the highest standards in providing you with reliable knowledge.

Learn more...

Is It Safe to Use an Anti-Epileptic in Pregnancy?

Mary McMahon
Mary McMahon
Mary McMahon
Mary McMahon

The safety of taking an anti-epileptic in pregnancy depends on the medication, the mother’s medical history, and factors like whether the mother needs additional drugs to manage other conditions. Overall, anti-epilepsy drugs are linked with a higher risk of birth defects, and some are worse than others. This risk should be balanced against the clear benefit of controlling epilepsy during pregnancy; if the mother experiences severe seizures, these could compromise the pregnancy, for example. Women with epilepsy who are pregnant or are planning to try for a baby can discuss the situation with an obstetrician and a neurologist for advice.

Concerns with using an anti-epileptic in pregnancy are centered on the first 18 weeks, when there can be a higher risk of congenital malformations, especially neural tube defects like those associated with spina bifida. Some research suggests that taking folic acid supplements can help with this problem, as can monitoring the mother’s blood carefully to check serum levels of the medication. At times, the concentration of the drug changes as a result of pregnancy-associated changes, in which case the risks of taking the drug can increase.

A pregnant woman should work closely with her doctor to weigh the risks and benefits of an anti-epileptic drug during pregnancy.
A pregnant woman should work closely with her doctor to weigh the risks and benefits of an anti-epileptic drug during pregnancy.

Carbamazepine is one of the safer anti-epileptics to use in pregnancy, and some neurologists also recommend valproic acid, although it can come with an increased risk of birth defects. Lamotrigine is also effective and can be used in some cases. Phenobarbital and phenytoin are generally not recommended because they are associated with a much higher risk of pregnancy complications, congenital abnormalities, and cognitive deficits in the child.

The bottom line is that any anti-epileptic is likely to increase the risks of birth defects when compared to the rest of the population, although the difference can be relatively slight. In a patient with severe epilepsy, however, the benefits of taking an anti-epileptic in pregnancy outweigh the risks in many cases, although a thorough evaluation may be recommended to confirm an epilepsy diagnosis and make sure the mother needs the medication. Using an anti-epileptic in pregnancy can prevent seizures that could threaten the life of mother, child, or both.

Women who decide to use an anti-epileptic in pregnancy may need to change medications to select the safest option, and could require monitoring to check for complications and assess serum levels. If they notice side effects, they should bring them up as soon as possible so they can be evaluated. In the event of pregnancy complications, birth defects, and other problems, mothers can report the problem to a drug database; some databases specifically record data on women with epilepsy to help determine which medications are safest, using information from women who had to use them during pregnancy.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a WiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...
Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a WiseGEEK researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Learn more...

Discuss this Article

Post your comments
Login:
Forgot password?
Register:
    • A pregnant woman should work closely with her doctor to weigh the risks and benefits of an anti-epileptic drug during pregnancy.
      By: Dmitriy Melnikov
      A pregnant woman should work closely with her doctor to weigh the risks and benefits of an anti-epileptic drug during pregnancy.