Antiepileptic drugs: review of safety of use during pregnancy

Following the known harms of valproate in pregnancy, MHRA released a report looking into the safety data for epilepsy medicines during pregnancy.

The Commission on Human Medicines has reviewed the available safety data for epilepsy medicines during pregnancy, following recognition of the serious harms (both physical and cognitive) linked to sodium valproate.

The findings from the MHRA Public Assessment Report from January 2021 indicates that lamotrigine (brand name Lamictal) and levetiracetam (brand name Keppra) are the safer of the reviewed antiepileptic drugs during pregnancy because they are not linked with an increased risk of birth abnormalities compared with the general population.

Carbamazepine (brand names Curatil, Tegretol), phenobarbital (brand names Phenobarbital Accord, Phenobarbital Elixir) or topiramate (brand name Topamax) use during pregnancy increases the risk of physical birth abnormalities compared with the general population

Doctors or specialist epilepsy nurses should use this information when discussing treatment options with women and girls with epilepsy when starting treatment and at routine recommended annual review, and with women who are planning a pregnancy.

For further information, see the full MHRA Public Assessment Report below.