Abstract

ANTIEPILEPTIC DRUGS: USE, SAFETY AND POSSIBLE ADVERSE EFFECT IN WOMEN WITH EPILEPSY DURING PREGNANCY AND CHILDBEARING AGE- A REVIEW

Sarita*, Neeraj Kumar, Sudhakar Kaushik and Preeti Kothiyal

Abstract

Epilepsy is a chronic medical disorder or condition resulting unpredictable recurrent seizures that can affect various mental and physical conditions. It is one of the most serious neurological conditions which affect 50 million people worldwide. Women with epilepsy during pregnancy and lactation suffer from various serious conditions. Choice of antiepileptic for women with epilepsy is also limited because of teratogenic effects of antiepileptic drugs. Conventional AEDs seen to be safer then newer AEDs for WWE, monotherapy seems to be safer as compared to polytherapy. Carbamazapine is the most commonly used AED found whether in monotherapy or in poly therapy. Valporic acid carbamazepine, phenytoin and phenobarbital are some conventional AEDs which are commonly used in WWE. Lamotrigine, gabapentin, felbamate oxcarbazepine, zonisamide, topiramate are some newer AEDs used in WWE. There is higher risk of major malformation among infants exposed to AEDs during pregnancy. Cleft lip, congenital heart defects, neural tube defects and other neurodevelopment risk are also associated with using AEDs during pregnancy. Folic acid and vitamin K supplement should be recommended for WWE in pregnancy and lactation. It helps in managing and reducing malformation risk in neonates and children. Management and counselling in WWE during pregnancy and lactation helps in teratogenic risk of AEDs.

Keywords: Antiepileptic drugs (AEDs), women with epilepsy (WWE), monotherapy, neurodevelopment, teratogenic and major malformation.