Andrea Navarro-Meza REVISTA ACTA ACADÉMICA NÚM 47 NOV. 2010
Most pregnant women with epilepsy require antiepileptic drug (AED) therapy. The guidelines recommend optimizing treatment prior to conception, choosing the most effective AED for seizure type and syndrome, using monotherapy and lowest effective dose, and supplementing with folate. The studies clearly show that valproate (VPA) as a part of polytherapy or when used as a monotherapy is associated with an increased risk of major congenital malformations compared with some other major antiepileptic drug. It is clear that women with epilepsy taking valproate and planning pregnancy should have a discussion with their physician about considering changing to another AED before pregnancy, if possible.