Antiepileptic drugs (AEDs) pose two types of possible problems for women of child-bearing potential. One is an increased risk for birth defects (all AEDs), and the other is the tendency of some (particularly Dilantin, Tegretol, phenobarbital, Mysoline, Trileptal, Topamax) of the AEDs to reduce effectiveness of birth control pills. These risks must be balanced against the risks of having seizures during pregnancy. Women should NOT stop seizure medicines without first discussing these relative risks with her physician. A study in the journal Epilepsy & Behavior (2009, volume 14, page 640) surveyed how often women taking these drugs were aware of the risks. A total of 148 women ages 18-44, living in Manhattan filled out a questionnaire on their awareness of how AEDs affect pregnancy or contraception. Respondents comprised an ethnically and racially diverse group. Overall, 60% were unaware that AEDs could affect birth control pills and 40% were unaware that AEDs could produce birth defects. These findings emphasize the need for more and better educational programs by doctors, healthcare institutions and websites such as epilepsy.com.

Robert S. Fisher, M.D., Ph.D.
Editor-in-Chief, epilepsy.com