Women with epilepsy who take multiple anti-seizure drugs are more likely to have problems conceiving, according to a recent study published in the medical journal, Neurology. Researchers in India found that among 375 women with epilepsy who were trying to become pregnant, 62 percent successfully conceived, usually within two years, while the remaining 38 percent remained infertile over an average of three years. Comparatively, the infertility rate among married women in the surrounding Indian state of Kerala is 15 percent.
The study showed that women with epilepsy had a higher-than-average infertility rate, and that those on multiple anti-epileptic drugs, or AEDs, had an even more difficult time becoming pregnant. Of the women on just one AED, 32 percent were unable to conceive during the study period. That percentage jumped to 41 percent for women on two AEDs, and to 60 percent for women on three or more anti-seizure drugs. Only 7 percent of women not taking the drugs were unable to conceive during the study period.
Women who take more than one AED tend to have more severe epilepsy. Researchers say that it is possible that the severity of the disease may play a role in a woman’s chance of conceiving. Most of the women in the study were taking older AEDs. Only a few study participants were taking the newer, more commonly used drugs in America, such as levetiracetam (Keppra), topiramate (Topamax), lamotrigine (Lamictal), and oxcarbazepine (Trileptal). Thus, researchers say they cannot comment whether the newer drugs may impair a woman’s ability to conceive.
The American Academy of Neurology and the American Epilepsy Society recommend that women who become pregnant reduce their AEDs to only one if at all possible to lower their chances of birth defects. Pregnant women are also advised to avoid older epilepsy drugs, such as valporate (Depakene, Epival), as well as phenobarbital (Luminal) and phenytoin (Dilantin).