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Epilepsy, Pregnancy & Keppra

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bubble1

New User, Becoming EHEALTHy
Joined: 17 Jan 2004
Posts: 16
Epilepsy, Pregnancy & Keppra
Posted: 01-21-04 14:29pm

I'm 30 years old and i've had juevenile myoclonic epilepsy since I was 17.

I got married 17 months ago so my husband and I are planning to start a family soon. I've recently been referred by my gp to see a neurologist for pre-conception counselling.

I'm currently on epilim chrono but the neurologist has told me that this has more of an increased risk of having a baby with spina bifida than other anti-epileptic drugs. Therefore, he wants me to transer gradually over to keppra which he says is considered to be a safer drug.

I was just wondering if anyone else has had children whilst on antiepileptic drugs - what did you take during pregnancy? How was your pregnany monitored? Did you find that being pregnant triggered of your epilepsy? I have read that the change in hormones can do that.
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Kathyalison

Experienced User , Rather EHEALTHy
Joined: 01 Apr 2004
Posts: 64
I'm In the Same Boat
Posted: 04-02-04 01:49am

Hi!
I'm in the same boat as you in many ways! I do have a child already although I am hoping for another.
When I was pregnant with my daughter (who is 23 months) I was on lamictal and had been for 5 years. The drug had worked well for me and was fabulous during my pregnancy. I had the maternal serum testing done to check for odds of spina bifida etc. And my results came back that my odds were considerably less than that of an average 26 year old (my age at the time). As well, on lamictal I was able to breast feed which was very important to me. Unfortunately I had to stop because I developed a very serious case of mateitis which lowered my seizure threshold and I did end up having a several seizures there after (my first in 16 months). However, I stayed on the lamictal and my daughter is wonderful! She reached a lot of her milestones earlier than the average child and is a talkitive bright little joy! Before I was married my doctor put me on lamictal partly because of it's considered safety during pregnancy. It is realitively new, and there are still a lot of studies being done with it I think, but I can tell you it was wonderful for me.

Now as I say, we're in the same boat, as my doctor now wants to change my meds, to include keppra because I have had some set backs and he feels we need to try to get on top of things. So he has been talking about keppra. My husband and I have been trying to concieve but have sadly put that on hold because of all of this. I've read about keppra and see a large list of side effects and evidence of fetal abnormalities in animals so I am terrified! Because lamictal did work so well for me, I really wanted to stay just with that, however...... Do you know anything more about keppra? I have read that keppra is to be used only in combination with other drugs. I haven't talked to my doctor about that yet, but I would mention it to your doctor if I were you.
As I say, lamictal was wonderful for me. In fact, i'd never felt better in my life!! My pregnancy was closely monitered but I always felt very confident! Good luck let me know how things go!
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bubble1

New User, Becoming EHEALTHy
Joined: 17 Jan 2004
Posts: 16
Pregnancy & Keppra
Posted: 04-02-04 03:11am

Hi

thanks a lot for your reply. I think you are right to be concerned about keppra - when I researched it, I found on the internet that the food & drug adminstration advised that foetal abnormalities had been found in animal studies and keppra hadn't been researched enough in human pregnanices. I've decided not to be a guinea pig so i've started to take topiramate. I've just started a gradual transfer from the epilim to topiramate.
I read lots about bad side effects of keppra - mainly depression and mood swings. When I expressed my concern to my gp, he advised me that I could look on the internet and type in any drug name and would always come across stuff like that but I kept coming across people saying don't go on keppra because for the first 3 months you think it's a wonder drug and then it affects your personality.

It will take me until end august to be fully transferred onto topiramate so we can start trying for a baby round that time. If i'm successful in becoming pregnant, i'm really worreid how I will cope because tiredness is the main trigger of my epilepsy. How did you find things with your first baby.

Thanks for your reply and good luck to you too!
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bubble1

New User, Becoming EHEALTHy
Joined: 17 Jan 2004
Posts: 16
Keppra & Pregnancy Again
Posted: 04-02-04 03:21am

Hi - me again - below is the article I read about foods & drugs administration with regards to keppra and epilepsy.

I found this article on: www.Epilepsy.Com/medicatio ns/b_keppra_pregnancy.Html

in the united states, the food and drug administration (fda) assigns each medication to a pregnancy category according to whether it has been proven to be harmful in pregnancy. Keppra is listed in pregnancy category c. This indicates that caution is advised, but the benefits of the medicine may outweigh the potential risks. Studies in animals have shown some harm to the baby, but there haven't been any good studies of results in women.

Talk to your doctor or another health professional if you are pregnant or plan to become pregnant. We don't yet have enough information to be able to estimate the risk of various types of birth defects that might occur if keppra is taken during pregnancy. We also don't know enough to compare the risk with keppra to the risk with other seizure medicines.

All women who are capable of becoming pregnant should take at least 0.4 mg (400 mcg) of the vitamin called folic acid every day because it helps to prevent one type of birth defect. (the most well-known of these is spina bifida, in which the spinal cord is not completely enclosed.) women at high risk, such as those with a history of this kind of defect in a previous pregnancy, should take 4000 mcg (4 mg) daily, beginning before they become pregnant.

How much keppra is passed through breast milk is not known for certain, but the way the body uses it suggests that probably a large portion does enter the milk. If you want to breastfeed your baby, check with your doctor about what seizure medicine would be best for you.
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Kathyalison

Experienced User , Rather EHEALTHy
Joined: 01 Apr 2004
Posts: 64
Pregnancy And Aeds
Posted: 04-02-04 04:26am

Hi!
Thanks for the info. I've read a lot of the same.
My pregnancy was wonderful. Like any woman I was very tired during my first trimester and this caused me some concern as like you my seizures are triggered by fatigue. However, I took good care of myself and around the 13th week things began to improve. The nausea had passed and I was gaining energy. As i've said to others, I never felt better than when I was pregnant. I was totally energetic and on cloud 9!!! The fatigue and tiredness did affect me after my daughter was born and I developed mateitis (an infection of the breast from breast feeding) which really impacted me though. The infection got so bad that I needed surgery (very rare!!) and this prompted a seizure. I had been really worried about handling labour because of course that is an extremely exhausting and demanding time. However, I had an epidural and flew through, and had a wonderful birth expereince! Because of the masteitis stuff though I was unable to continue breast feeding and this really impacted me. I developed post-partum depression in there (which we figured out several months later) after a seizure took place. This was oct 2002.
Due to this, my doctor has wanted to change my meds for the last while, and is now wanting to add keppra as I said. But, with my history of depression (which i'm sure had nothing to do with epilepsy or the lamictal) i'm really worried about that side effect of keppra. I'm literally sitting by the phone right now waiting for him to call. Not knowing is the worst, and I so want another baby!!! It's hard when your fate and that of your family is in someone else's hands. Hang in there! Your miracle will happen and I pray mine will too.
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denenne

New User, Becoming EHEALTHy
Joined: 26 Jun 2004
Posts: 5
Location: portland or

Posted: 06-28-04 18:39pm

Hello,

i was reading and thought I would put in my two cents. I have had seizures since the age of 7 and have been on tegratol until this last year when I changed to trileptal. I have to children ages 8 and 5 and they are both very healthy. The only issues that I would look for is in labor you may have seizure if fatigue is your trigger. Let your ob/gyn know and they will be able to give you other meds to calm you and they will let you sleep good then induce your labor, also dont let your body fool you after labor you have not yet recovered from the fatigue and you are not getting a lot of sleep anyway. I never have grand mals unless I am asleep, but after labor I have one when I was driving with my kids in the car. Thank god no one was hurt. Just take care of yourself first and you will be fine.

Good luck
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