Prescribing in pregnancy. Epilepsy in pregnancy

In women with epilepsy, seizure control during pregnancy can be improved by maintaining the serum anticonvulsant drug concentration within the therapeutic range. Treatment with one anticonvulsant drug plus folic acid supplementation 5 mg per day seems appropriate in most cases. This should be achieved before conception whenever possible. No anticonvulsant drug seems free of teratogenic risk. With the commonly used anticonvulsant drugs-phenytoin, phenobarbitone, carbamazepine and sodium valproate-the risk is relatively low and represents less potential harm to the fetus than might occur with uncontrolled seizures.