Treatment options for pregnant women with epilepsy.
BACKGROUND
Antiepileptic drugs (AEDs) in pregnancy are associated with an increased risk of fetal malformations. Concern is expressed about the effects that AEDs may produce on the child's cognition and development. To date, no specific malformations have clearly been proven to be attributable to a specific drug, with the exception of valproate.


OBJECTIVE
In order to gain prospective data, collaborative pregnancy registers have been established which collect data on teratogenicity and seizure control efficacy of AEDs, and on the comparative efficacy of second-generation AEDs.


METHODS
Studies of the effects of AED exposure on cognitive function have begun. Future head-to-head studies of traditional and newly developed AEDs may provide a more rational basis for defining first and second line choices of medications for women with epilepsy generally, and more specifically in pregnancy.


CONCLUSIONS
Traditional prescribing patterns appear to influence the options for treatment of women with epilepsy in pregnancy, which is then adjusted according to the variability of response.
Vajda
F J E
FJ
Monash University, Victoria, Australia. frank.vajda@med.monash.edu.au
D000014:Abnormalities, Drug-Induced / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003071:Cognition / Q000187:drug effects; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D005333:Fetus / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects; D012042:Registries
D000927:Anticonvulsants