Epilepsy treatment and pregnancy
If you are a woman with epilepsy, please refer to our comprehensive section for women with epilepsy.
If you are planning a pregnancy it is advisable to speak to your neurologist about your medication in case changes need to be made. Some drugs are safer than others in pregnancy. Certain epilepsy medications (in particular Valproate/ Epilim) can affect foetal development and it is important to discuss the risks with your medical team before becoming pregnant. Most women with epilepsy have healthy pregnancies and healthy babies while on medication, but good antenatal care is very important. Many pregnancies are unplanned too so speaking to a specialist nurse is very important if this should happen. You should not stop taking your medication without medical advice as seizures pose risks too. The higher dose (5mg) of folic acid is recommended for women with epilepsy of childbearing age. Epilepsy Ireland provides information for women with epilepsy relating to family planning and pregnancy.
Foetal Anti-Convulsant Syndrome
Foetal anti-convulsant syndrome (FACS) is a condition that can affect some babies if they are exposed to certain epilepsy drugs during pregnancy. Research shows that older epilepsy drugs are most linked with FACS, particularly Sodium Valproate or Valproate, commonly known as Epilim. Valproate has been shown to cause birth defects and developmental problems in the babies of women who took it during pregnancy. Even low doses pose risks and the risks increase with higher doses. Valproate should be avoided for women and young girls unless nothing else will treat their seizures. For more information on this, see our section on Valproate risk.
For pregnant women taking Valproate the risk of a birth defect is 10 out of 100 babies, which is 3-5 times higher than in the general population. These birth defects can include malformations of the spine, face, skull, limbs and organs. Also up to 40% of babies may have developmental difficulties which can range from mild to severe, including delayed milestones, intellectual delay, speech and language delays, ADHD and autism. If you are a woman of childbearing potential taking sodium valproate then it’s essential that you have regular reviews with your medical team. If you are taking any AEDs and aren’t planning a family you will need to discuss contraception options with your doctor. If you become pregnant while taking any epilepsy medication, don’t stop taking your medication but speak to your doctor as soon as possible.