Epilepsy and pregnancy

[Rainbow1808]

So I’ve just recently found out I’m pregnant. I have epilepsy and I’m on lamotrigine 450mg a day. I need to know if my medication needs to change or be lowered but my consultant is away until the 28th and my GP has no idea Does/has anyone else taken this medication whilst pregnant? Also, wondering if there is any difference in pregnancy when you have epilepsy. This is DC2, but wasn’t diagnosed with epilepsy when I was pregnant with him. I am very much a worrier so any experiences would be appreciated!

[Waggers91]

Hi @rainbow1808 I also have epilepsy and I am 18w pregnant.

I would recommend speaking to your neurologist or epilepsy nurse or failing that epilepsy society has some good articles. I am on Keppra at 2500mg a day, I understand that Keppra and Lamotrigine are the safest drugs to be on when pregnant.

You should be taking high dose folic acid too, or at least that was the advise I was given.

Hope that helps

[Pygmyseahorse]

Congratulations

I'm epileptic and pregnant. Was on keppra with dd had the most hideous seizures from second trimester onwards

This time I'm on lamotrogine
It's a planned pregnancy and I spoke to my epilepsy nurse and consultant before and they both said that lamotrogine is one of the safer medications during pregnancy

You may need higher folic acid for a start, have you been on this? I'm on 5mg per day and I take a combined vit d with folic acid too.

You will likely be consultant led care and seen by the epilepsy clinic during your pregnancy. My first appointment with them is when I will be about 15 weeks or so
They do bloods to see how much meds is in your system and see how your seizures are. In pregnancy your blood level increases so its common for the meds to be increased often.
If you have sickness and can't keep meds down go to your gp right away, I have HG and had it with dd and so couldn't keep my epilepsy meds down most of the time.

Have you got a booking appointment with your midwife arranged? That will automatically alert them to get you a consultant and process starts. If not then give them a call on Tuesday. You can try calling your nurse or consultant but I'm having issues with that due to corona

It's a good idea to make a seizure diary and take that to an appointments

Try to rest and eat as you can as that may trigger seizures for some

With any medication in pregnancy it comes with risks but I was constantly told that seizures are more harmful so keep taking your meds as prescribed

You may get an extra detailed scan and/or the 20 week anomoly may take longer with checks related to medication specifically

Good luck and I hope you have a healthy pregnancy

[TenThousandSpoons0]

Congratulations :)
Pretty disappointing that your GP doesn’t know (and hasn’t just looked it up for you) - it’s pretty straightforward in the early stages.
You don’t need to do anything differently with your lamotrigine right now - most important thing is to keep taking it! Sometimes the dose is adjusted upwards during pregnancy (not reduced) but that depends completely on your own circumstances and doesn’t need to happen urgently (unless you have been having lots of seizures in recent months, in which case best to urgently discuss with GP or neurologist and possibly organise some lamptrigine levels). Hopefully you’re already taking high dose folic acid - if not, get yourself some, 5mg/day is the dose.
There’s no increased risk to baby with lamotrigine, and most women with epilepsy have pretty straightforward pregnancies. There will be some different advice as time goes on, such as strategies for making sure you and baby are safe (things like bathing baby safely in case you have a seizure etc). You may also have slightly different plans around the time of delivery to try and limit sleeplessness for example, as that’s often a trigger for people.
Congrats again x