EPILEPSY AND PREGNANCY

PREGNANCY

FIRST CHOICE:

Levetiracetam 

Lamotrigine (100 bid is the standard dose in adults)

Start 25 OD for 2 weeks then 25 bid 2 weeks then increase by 25 mg every 2 weeks till 50 bid then 50mg every 2 weeks till 100 bid) 

 

SECOND CHOICE

Lacosamide 100 bid

Zonisamide 200 bid

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During pregnancy slowly increases the dose of levetiracetam and lamotrigine by 50 percent due to increased bioavailability

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AVOID IN PREGNANCY

Oxcarbamazepine ( adult standard maintenance dose 450 bid)

Carbamazepine (adult standard maintenance dose 400 bid )

Stop immediately/ suddenly and load with levetiracetam

 

Note: All antiepileptic drugs can be given OD or BID