Antiepileptic Drugs and Pregnancy: The Future

Abstract

The study of the interaction between antiepileptic drugs and the pregnant human female body that has gone on over the better part of half a century has provided evidence that the currently available drugs are inactivated more quickly during pregnancy and that they possess to various degrees responsibility for the occurrence of malformations in the body structures of foetuses exposed to them, and also, at least in the case of valproate, for impaired neurodevelopment in infancy and childhood. As the drugs in current use come to be replaced by newer agents, there will be a need to maintain, and hopefully expand, the current data-collecting mechanisms that have so far provided the information about the teratogenicity of the antiepileptic drugs. While application of knowledge that is already available has made possible both better epileptic seizure control in pregnancy, and a reduced incidence of foetal malformations, it is uncertain how widely this knowledge has been disseminated and, after dissemination, has been applied. The available knowledge also points to other matters that warrant investigation.