Guidelines confirm safety of pregnancy in women who have epilepsy—with caveats

Counsel the mother about breastfeeding concerns

• Women who have epilepsy and who choose to breastfeed should be counseled that primidone and levetiracetam probably pass into breast milk in significant amounts. In addition, gabapentin, lamotrigine, and topiramate may pass into breast milk in significant amounts. In contrast, valproate, phenobarbital, phenytoin, and carbamazepine probably do not pass into breast milk in clinically important amounts.
  

The guidelines were developed after a review of all scientific studies available on each topic and were published in the online issue of the journal Epilepsia. Their development was supported in part by the Milken Family Foundation.

“For too long, women living with epilepsy have feared the added risk of premature birth and other consequences of both their epilepsy and their medications,” said Howard R. Soule, PhD, chief science officer for the Milken Family Foundation. “The results of this project will help relieve the worries of these women and their families.”

For more on the guidelines, visit the American Academy of Neurology Web site at: www.aan.com/index.cfm?axon=redirect&&path=/go/practice/guidelines.