4.8 – Antiepileptics

Epilepsy is one of the most common chronic neurological conditions during pregnancy and postpartum (3–5 of 1,000 births) requiring continuous treatment. The clinical use of antiepileptic drugs has extended beyond the treatment of seizures and also plays a significant role in the management of neuropsychiatric disorders including bipolar disorders, impulse-control disorder and pain syndromes. With monotherapy some antiepileptic drugs like carbamazepine, gabapentin, phenytoin, valproic acid are acceptable during breastfeeding, although their teratogenic potential has to be discussed with the patient. Many others like clonazepam, lamotrigine, phenobarbital, vigabatrine are only conditionally acceptable. This chapter reviews all the antiepileptic drugs in regard to their safety during breastfeeding and gives recommendations for clinical practice.