MHRA reviews risk of epilepsy medications during pregnancy

Most women with epilepsy have a healthy pregnancy, but there are some risks linked to epilepsy medication that should be discussed with you before trying to conceive.

Most women with epilepsy have a healthy pregnancy, but there are some risks linked to epilepsy medication that should be discussed with you before trying to conceive.

Doctors in the UK have been already been advised not to prescribe valproate to girls and women who could get pregnant or who are pregnant, unless other epilepsy medicines don't suit them. Valproate medicines include sodium valproate (Epilim, Depakote) and valproic acid (Convulex). If you’re taking valproate and want to get pregnant, it’s important to speak to your GP before stopping your medication.

Following a review by The Medicines and Healthcare products Regulatory Agency (MHRA), women who are currently having treatment for epilepsy are being asked to discuss their treatment with a healthcare professional, to ensure their medication is right for them. This is important if you are planning to become pregnant or if you think you may become pregnant in the future.

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If a woman is planning to become pregnant, and is taking a medicine for epilepsy, even if this is some time in the future, it is very important that she should discuss with a healthcare professional the right treatment for her, taking into account the results of this review.

— Dr Sarah Branch, Director of MHRA's Vigilance and Risk Management of Medicines Division

The review by MRHA found that the anti-epileptic medicines lamotrigine (Lamictal) and levetiracetam (Keppra) are safer than other anti-epileptic drugs in pregnancy.

The MHRA advice is clear that you should not stop taking your current medication without discussing it first with a healthcare professional.

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It’s important to discuss with your doctor if you are considering stopping medication for long-term conditions completely or altering the dose as this can pose a serious risk to your health. We advise that women with epilepsy should seek advice and information from their doctor pre-conception as well as throughout their pregnancy.

— Dr Jo Mountfield, Consultant Obstetrician and Vice President at the Royal College of Obstetricians and Gynaecologists

Planning a pregnancy with epilepsy

If you’re planning to have a baby, the aim of your treatment will be to manage your condition as effectively as possible during pregnancy.

This means finding a medication regimen that will control your seizures effectively and minimise the risk of harm to your baby’s development in the womb as much as possible.

This may involve making changes to the medication you’re taking at the moment. This should be done before you conceive.

If you are taking anti-epileptic medications, ask your GP to refer you for pre-conception counselling. This will be an appointment with a doctor or nurse who knows about pregnancy and epilepsy. 

They can talk to you about how epilepsy affects you and the risks and benefits of all treatment options before you become pregnant. These include:

  • carrying on with your current medication regimen
  • adjusting your medication
  • stopping your treatment altogether.

Please remember you should not stop taking your current medication without discussing it first with a healthcare professional.

Find out more about epilepsy and planning a pregnancy.

Read more about planning a pregnancy