9. Effect of Pregnancy on AED Kinetics

  1. Cynthia L. Harden MD Professor of Neurology3,
  2. Sanjeev V. Thomas MD, DM Professor of Neurology4 and
  3. Torbjörn Tomson MD, PhD Professor of Neurology and Epileptology5
  1. Peter B. Forgacs1 and
  2. Page B. Pennell2

Published Online: 24 JAN 2013

DOI: 10.1002/9781118531037.ch9

Epilepsy in Women

Epilepsy in Women

How to Cite

Forgacs, P. B. and Pennell, P. B. (2013) Effect of Pregnancy on AED Kinetics, in Epilepsy in Women (eds C. L. Harden, S. V. Thomas and T. Tomson), John Wiley & Sons, Oxford. doi: 10.1002/9781118531037.ch9

Editor Information

  1. 3

    Chief, Division of Epilepsy and Electroencephalography, Hofstra North Shore-LIJ School of Medicine, Cushing Neuroscience Institutes, Brain and Spine Specialists, North Shore-Long Island Jewish Health System, Great Neck, New York, USA

  2. 4

    Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala State, India

  3. 5

    Karolinska Institutet, Stockholm, Sweden

Author Information

  1. 1

    Rockefeller University, New York, New York, USA

  2. 2

    Division of Epilepsy, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA

Publication History

  1. Published Online: 24 JAN 2013
  2. Published Print: 11 MAR 2013

ISBN Information

Print ISBN: 9780470672679

Online ISBN: 9781118531037

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Keywords:

  • pregnancy;
  • gestation;
  • epilepsy;
  • pharmacokinetics;
  • women with epilepsy

Summary

A major concern for women with epilepsy at childbearing age involves finding an optimal antiepileptic drug (AED) regimen in preparation for planned or unplanned pregnancies. The foremost challenge for the physician is to minimize the possible teratogenic and developmental side effects of AEDs on the fetus while maintaining seizure freedom in the mother. The understanding of how gestational physiologic changes alter the pharmacokinetic properties of certain AEDs, and therefore drug levels in plasma, is fundamental for optimal management of women with epilepsy. The chapter details the expected pharmacokinetic changes related to pregnancy and the implications for management at various perigestational stages: before conception, during the pregnancy and after birth.