Epilepsy drugs force pregnant women to make tough decision

Many doctors argue that it is just as risky for pregnant mothers not to take anti-epilepsy medication, as epileptic seizures can also harm a fetus. Research is still inconclusive, though, as some effects of the medication may not manifest until the child is grade-school age.

• An article in the journal Epilepsia reviewed recent data on the risks associated with continuation of medical treatment of women with epilepsy during their pregnancies.
• While the general consensus is that use of antiepileptic drugs is associated with increased risk for birth defects, physicians weigh this risk against that of uncontrolled epileptic seizures, which can be more harmful to the fetus than the actual drugs.
• Most women with active epilepsy choose to continue with drug therapy during pregnancy and have more than 90% chance to give birth to a perfectly healthy child.
• One drug, valproate, has been associated with a higher risk of birth defects than some others although the reasons for this have not been completely clarified.
• However, for some patients, valproate is the most effective medication for controlling the seizures, which must be balanced against the risk.
• The Commission on Genetics, Pregnancy, and the Child of the International League Against Epilepsy (ILAE) developed guidelines in 1989 for the care of women with epilepsy of childbearing age, including the optimization of treatment before conception and using lowest effective dosages for seizure type and syndromes.
• With this new review, doctors have more data and advice until more conclusive data is reached.
• It is a non-profit and non-governmental association, with official links with the World Health Organization and the International Bureau for Epilepsy.
• It is the world's preeminent association of physicians and other health professionals working towards a world where no persons' life is limited by Epilepsy.
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