Antiseizure Medication Dose Increases During Pregnancy Common for Women With Epilepsy

TUESDAY, Jan. 6, 2026 (HealthDay News) — More than two-thirds of pregnant women with epilepsy (PWWE) receiving antiseizure medications (ASMs) have dose increases during pregnancy, according to a study published online Dec. 29 in Neurology.

Page B. Pennell, M.D., from the University of Pittsburgh School of Medicine, and colleagues examined how ASMs were dosed in a large observational cohort study of PWWE, ages 14 to 45 years and at <20 weeks” gestational age, who had favorable seizure outcomes. The percentage of participants who underwent dose changes was examined in pregnancy and postpartum for each ASM.

Overall, 299 participants were eligible for analysis. The researchers found that 67.8 percent of ASMs had dose increases during pregnancy, beginning at a median of 32 days postenrollment. For 47.9 percent of ASMs, dose decreases were made within six weeks postdelivery, beginning at a median of three days postpartum. For lamotrigine, 87.7 percent of participants had doses increased, by a median of 100 mg/day, reaching a mean of 191 percent of conception dose by delivery; 70.5 percent had dose tapers by a median of 100 mg/day postpartum, reaching a mean of 116 percent of conception dose by six weeks. For levetiracetam, 56.0 percent had doses increased by a median of 500 mg/day, reaching 177 percent of mean conception dose by delivery; 34.4 percent had dose tapers postpartum, to 136 percent of conception dose by six weeks.

“Our goal was to generate practical evidence that empowers clinicians everywhere — from rural hospitals to urban subspecialty centers — to provide the best possible care for women with epilepsy during pregnancy,” Pennell said in a statement.

Several authors disclosed ties to the biopharmaceutical industry.

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