Question of the Week

Question :
Posted On : 26 Mar 2020
thank u very much for d last query :}
what shuld be d drug of choice for a woman wid epilepsy during pregnancy and lactation_? are thr recent changes_? Is carbamazepine preferred over phenobarbitone_? and what about during lactation any datas available_?
LOOKING forward for you help..
thank you :}
Expert Answer :
Phenytoin increases the risk of neural tube defects by approximately 10 per cent {highest overall rate}. Valproic acid increases the risk of neural tube defects by approximately five to nine per cent. Carbamazepine increases the risk of neural tube defects by approximately one per cent {lowest teratogenic effect}. Thus Phenytoin and valproate should be avoided as far as possible.

Use of some newer antiepileptics during pregnancy minimally increases the rate of neural tube defects:

Lamotrigine: Preliminary data from pregnancy registries around the world suggest no increased risk for birth defects with the use of lamotrigine. However, the North American Antiepileptic Drug Pregnancy Registry suggests a potential increased risk for non-syndromic cleft palate, which was observed among 564 exposed infants

Less than five per cent of the mother’s dose of any antiepileptic drug is excreted into breast milk. Antiepileptics can therefore be used safely during breastfeeding.
Answer Discussion :
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