Teratogenesis with antiepileptic drugs: practical management of young women with epilepsy

Children born to mothers who take antiepileptic drugs during pregnancy have a 2-4 fold increased risk for birth defects and also a risk of growth retardation and possibly impaired psychomotor development. Despite their teratogenic effects, antiepileptic drugs are used during pregnancy because uncontrolled epileptic seizures are considered more hazardous to the fetus than the drug therapy. The aim is to maintain seizure control with the appropriate drug given in monotherapy at the lowest effective dosage. These issues have implications for the management of young women with epilepsy in general, since major changes in drug therapy and other attempts to reduce the teratogenic risks should be accomplished before conception in order to be effective and safe.