About Dr. Blanca Vazquez >>
I have epilepsy and am currently taking anti-epileptic drugs for treatment. What should I do if I am planning to become pregnant?

Most females with epilepsy have a healthy child. It is important for every woman to speak with their doctor when preparing for pregnancy in order to receive the appropriate prenatal care. As a woman with epilepsy, it is especially important to have regular appointments with your neurologist as well as with a gynecologist or obstetrician before planning to get pregnant. Before getting pregnant, be sure to ask your doctor about all of the medicines you are taking. It is important to continue taking your medication throughout the pregnancy, since uncontrolled seizures can harm the development of the fetus. There are published data that suggest some anti-epileptic drugs may have less risk than others when used during pregnancy. Also, to help reduce the risk of certain birth defects, it can be beneficial to take vitamins with folic acid prior to and throughout pregnancy. After you become pregnant, be sure to visit your obstetrician often to help ensure a healthy and successful pregnancy. Also, it is important to consider talking to your doctor about joining a Pregnancy Registry.

I'm taking birth control. Will birth control affect my anti-epileptic drugs? Will my epilepsy medicine affect my birth control?

Some anti-epileptic drugs may lower the amount of the female hormones in your body Also, the opposite may be true: some hormones may decrease the amount of anti-epileptic drug in the body. If you currently are, or want to start, using any form of birth control, ask your doctor about the best method for you.

Certain types of birth control work by using female hormones to prevent pregnancy. These types of birth control include: These birth control methods work by providing hormones (estrogen and/or progesterone), which prevent the ovaries from releasing an egg, or interfere with the fertilization of the egg. Since some anti-epileptic drugs reduce estrogen levels, this may mean that there is not enough estrogen for these forms of birth control to work properly, which can result in unplanned pregnancy. If you currently are, or want to start, using any form of birth control, ask your doctor about the best method for you.

I am going through menopause, and I feel like my body is going through many changes that I can't control. Will these changes affect my epilepsy and/ anti-epileptic drugs?

During perimenopause, the years leading up to menopause, the ovaries gradually begin to make less of the hormones estrogen and progesterone. Blood levels of the two hormones start falling, often in a kind of seesaw pattern. For females with epilepsy, this erratic reduction in one hormone, then the other, can have dramatic effects: Hormone Replacement Therapy may affect other medications you are taking. It is important, for this reason, for females going through menopause to visit their doctor regularly to decide on the appropriate epilepsy treatment for them.

Should I be concerned about bone loss? I have heard that women with epilepsy have increased risk of osteoporosis.

Bone loss, meaning your bones become less dense, may occur earlier in females who take certain anti-epileptic drugs long-term. Severe bone loss can lead to a dangerous condition called osteoporosis, in which thin, brittle bones may break easily. It is important for females with epilepsy to take extra calcium, to exercise throughout their lives to preserve bone health, and to discuss with their doctor if their medication may be contributing to bone loss.

My 14 year-old daughter has epilepsy, and I am concerned about the changes in her body as she goes through puberty. How will these changes affect her anti-epileptic drugs? Are there particular things I should be aware of?

Side effects from some anti-epileptic drugs, for example, may include menstrual irregularity, weight gain, unwanted hair growth and feeling tired or "out of it." It's no surprise that some girls will want to stop taking their medicine, or may "forget" to take it. Skipping or stopping medications can lead to increased seizure frequency. Common teenage behaviors such as staying up late (lack of adequate sleep), experimenting with alcohol or drugs or cramming for tests can also create physical stress, which in turn may increase the risk of breakthrough seizures. Most doctors will want to see teenage girls more often during this time of life. At this age, an increase in medication dosage may be needed to ensure effective seizure control during growth spurts. The goal is to manage possible changes in seizure pattern and also reduce side effects.



The survey was funded through support from GlaxoSmithKline