35 years old female suffering from grandmal epilepsy since 2 years. Initially put on tab Oxcarbamazepine 300mg BD. But fits recurrent. Tab levecetram 500 mg O.D was added. .Since then patient is stable. Now she had conceived. What should be done regarding continuation of drugs in pregnancy. Are these safe. If not how to manage this situation



Not a single anti epileptic is safe during pregnancy, but u better don't change. Levecetram is comp safe. Put her on 2_4 tsf of duphalac or white cremafin. Or daily insertion of 1_2 dulcolax suppositions in morning hrs. Lot of buttermilk & leafy vegetables in diet . More of fibers.

Mam , any specific benefit of laxatives along with anti epileptics

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Please build on dose of levecetram. Please don't taper or change medicines. A seizure now can be catastrophic. Of course there are side effects of the AEDs, but not taking them puts the mother at risk of convulsions which, and I repeat, can be catastrophic. Add folate, but talk to the obstetrician. Folate can have teratogenic effects in over adequate dose.

For grandmal epilepsy oxcarbazepine is a bad choice U can continue levitiracetam Slowly taper oxcarb Start on folic acid, methylcobalamine

Sir , Levecetram is safe in pregnancy, Oxcarbamazepine also has no proved study of having any effect on fetus nor on IQ of baby( as per study). But regarding use of antiepileptic drug in pregnancy,the protocol should be... *To change to safer drug 6 months before conception. *To give folic acid minimum for 3 months preconceptionally,5 mg od because folic acid reduces the harmful effects of these drugs. *If already on one drug continue it. *NO DRUG IS SAFE IN FIRST TRIMESTER. *Best is to give one drug. Here,as patient is already stable on Oxcarbamazepine and Levecetram... continue these. Add folic acid. Continuous fetal monitoring is important here. Adv NT scan at 12 wks. Anomaly scan at 19-20 wks.

Almost all antiepileptic drugs are not safe in pregnancy.Continue the same treatment and consult the Neurophysician for her follow-up.

Protocol is that to put patient on single drug Tab levecetram is relatively safe Continue folic acid whole pregnancy NT scan at 12 - 13 weeks Good anomaly scan at 19 to 20 weeks

Risk factor is more, refer to Gyanecologist.

Please continue with same antiepileptic drugs

Agree with Dr sailesh modi, taper and stopOXY carb and increase the dose of levecetram

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