ANNOUNCER: Another reason that a woman with epilepsy needs to plan her pregnancy, is that anti-epileptic medications have been associated with an increased risk of birth defects.
CYNTHIA HARDEN, MD: We do not have a specific anti-seizure medicine at this time that has been shown to be completely safe during pregnancy. The types of birth defects that are associated with anti-seizure medicines are the same as in the general population, and these include the most common sorts of birth defects, like cleft lip, cleft palate; also cardiac defects, holes in the heart, so to speak, or other malformations of the heart; and then spinal cord defects, specifically lack of closure of the lower spinal cord.
ANNOUNCER: Not all anti-seizure medications are associated with all of these birth defects. And there is some evidence that the newer anti-epilepsy drugs pose less risk, although more data is needed.
CYNTHIA HARDEN, MD: There seem to be several that have emerged as possibly being worse than the others. This would include Depakote†, which appears to have a higher risk of the spinal cord defects, and phenobarbital, which recently has been reported to have a higher-than-expected rate of birth defects associated with it and these are largely cardiac.
Outside of these two medications, it's not clear that any of the others are that much different. In addition, with a whole new generation of anti-seizure medicines, although they've been widely used throughout the world, we still don't have enough information to clearly counsel our patients.
