Epilepsy, drugs and pregnancy

Aug 19, 2008 4:10 PM

If you're a woman with epilepsy, one of the challenges you may face is managing your condition if you want to get pregnant (subscribers only). It's important to avoid seizures during your pregnancy.

Happily, more than 9 in 10 women with epilepsy go on to have a healthy baby. But epilepsy drugs are linked to a higher chance of having a baby with birth defects.

Researchers are trying to find out which drugs, or combination of drugs, are safest for women and their babies. Older drugs like valproate (subscribers only) have a higher risk of certain birth defects. But there's been less research about newer drugs.

The latest research looked at a drug called topiramate (brand name: Topamax). The research found links between topiramate and some birth defects, but overall, topiramate didn't seem to be worse than other epilepsy drugs.

The study, carried out in the UK, found a higher-than-average risk of two types of birth defect with topiramate. Babies whose mothers had taken the drug were more likely to have a cleft lip or palate (where the baby's mouth doesn't form properly) and hyperspadias (a condition in baby boys, where the genitals don't form properly). Both of these conditions can be corrected by surgery after the baby has been born.

Generally for women taking epilepsy drugs, there are 4 to 9 birth defects for every 100 babies. Between 4 and 5 in 100 babies whose mothers took topiramate alone had a birth defect.

When women took topiramate and another epilepsy drug together, the risk was higher. Some doctors think it's best for pregnant women with epilepsy to take just one epilepsy drug, if they can manage on that without having seizures.

What you need to know. If you're considering having a baby and you have epilepsy, talk with your doctor as soon as you can. Your doctor may want to adjust your medication, change the dose or move you to another drug in order to give you the best chance of a healthy pregnancy. Changes in medication can take a while to get right, so allow as much time as you can.

—Anna Sayburn, patient editor, BMJ Group

ConsumerReportsHealth.org has partnered with The BMJ Group to monitor the latest medical research and assess the evidence to help you decide which news you should use.

Read our full Treatment Ratings for epilepsy (subscribers only), and find out which questions you should ask your doctor if you have epilepsy and thinking of having a baby (free).