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• Posted December 6, 2024

Many Women With Epilepsy Unaware of Seizure Meds' Risks to Pregnancy

Many women with epilepsy who are of childbearing age might not realize their anti-seizure drugs can raise the risk of birth defects or dampen the effectiveness of their birth control, a new study warns.

Likewise, some birth control methods can cause anti-seizure meds to be less effective, researchers reported Friday in a presentation at the annual meeting of the American Epilepsy Society in Los Angeles.

“Many neurologists do not learn about birth control in their training, even though they know that anti-seizure medications may have some risks in pregnancy,” said senior researcher Dr. Sarah Betstadt, an associate professor of obstetrics and gynecology at the University of Rochester Medical Center. 

“We hope this study raises awareness for patients and encourages health care providers from neurology and reproductive health care to work together to ensure the best care for these patients,” Betstadt added in a society news release.

For the study, researchers surveyed 107 women ages 18 to 49 who were taking anti-seizure medications about their reproductive plans.

Six said they were pregnant or planning to become pregnant, and another 69 said they were using some sort of birth control that could interfere with their anti-seizure meds, researchers said.

The survey quizzed women on their knowledge regarding birth control and anti-seizure meds, and found that:

• Two-thirds (67%) of all the women answered at least one question incorrectly regarding the ways birth control can interfere with anti-seizure medications and vice-versa

• 56% of those who want to become pregnant answered at least one question incorrectly about the birth defect risk posed by anti-seizure drugs

• 36% of those actively using birth control showed some ignorance of the way it can interact with anti-seizure meds

• 73% felt they didn’t need any more education about these risks

• Only 29% of those who displayed any ignorance of the interaction said they wanted more education

“Survey participants may not have known that their answers were wrong and so did not feel they needed more information,” Betstadt noted.

Only about a third of the women were receiving medical care that aligned with their reproductive plans, researchers found.

Anti-seizure medications that increase the risk of birth defects include valproic acid, topiramate, carbamazepine, phenobarbital and phenytoin.

Further, anti-seizure drugs that can make hormonal contraceptives like pills, patches and rings less effective include carbamazepine, phenytoin, phenobarbital, and higher doses of topiramate and oxcarbazepine.

Despite that, no anti-seizure drug is as dangerous for an expecting mother or her fetus as uncontrolled seizures, the researchers noted.

Women who want to become pregnant should talk with their doctor about drugs that are less risky but still can control their seizures, researchers said.

“Neurology and reproductive health care providers should collaborate to provide the safest and most effective care for their patients of reproductive age who are taking anti-seizure medications,” Betstadt said.

“This collaboration can help patients navigate their reproductive choices while minimizing drug-drug interactions that may reduce the effectiveness of seizure medications and/or birth control methods,” Betstadt added.

Findings presented at medical meetings should be considered preliminary until they’re published in a peer-reviewed journal.

More information

The Epilepsy Foundation has more on birth control and epilepsy.

SOURCE: American Epilepsy Society, news release, Dec. 6, 2024