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How to eliminate the side effects of epilex during pregnancy ?

Dear Dr , My daughter, 33 is having Petit mall since she was 8 yrs old. She is taking Epilex Crono 500 twice a day. Recently she delivered a baby girl who expired within 15 days due to side effects of the drugs. Should we change the drug to eliminate the side effects of sodium valporate. The baby had Cleft pallate, hole in the heart & developed pneumonia . Her next pregnancy should be free from such side effects. Kindly advice. Thank you. Truly yours, subhash banthia email:
Asked On : Tue, 12 Jul 2011
Answers:  5 Views:  145
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Emergency Medicine Specialist 's  Response
if ur daughter plan for next pregnacy ,1st thing is when was last episode of attack ,may be discontinue with tappering or safe drugs for prgnancy also available ,consult to Gynaecologist and nerophysician could be helpful for u
Answered: Tue, 12 Jul 2011
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Psychiatrist Dr. Keerthish Shetty's  Response
Hi Subhash,
It is really unfortunate that you and your daughter had to go through all this. Such situations are commonly faced by epileptic patients who become pregnant. Here are some tips which should help
1. Always consult your treating doctor (neurologist/psychiatrist) before planning pregnancy.
2. Once pregnancy is planned, the doctor can then guide you regarding the options available. It is a very tricky situation and the decision is usually taken after weighing the risks and benefits, as all anti-epileptic medication have side effects.
3. Once decision is taken to continue with pregnancy, she has to be monitored regularly by obstetrician. If congenital problems are noticed (during anamoly scan), then the pregnancy can be terminated.
Answered: Thu, 14 Jul 2011
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General & Family Physician Dr. Ramesh M.Vachharajani's  Response
Thanks for query,
During pregnancy medicines should be changed.
Now if she wants pregnancy consult psychiatrist and seek his advice.
He will prescribe the medicines which are having least side effect on the fetus.
She should plan accordingly as old drug is withdrawing gradually and new drug introduce with low dose.
Ok and bye.
Answered: Tue, 12 Jul 2011
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Psychiatrist Dr. A. Vishal's  Response

sodium valproate is good drug for control seizures, but it is not safe during 1st 3months of pregnancy, because it may cause neural tube defect and facial anomalies.Intrauterine first-trimester valproate exposure has higher risk of major congenital malformations compared to carbamazepine, and possibly compared to phenytoin or lamotrigine.

for this case you should start prophylactic folicacid tablets, consult psychiatrist and he may gradual taper the dose of valproate change to another anti epileptic medication.
Answered: Wed, 13 Jul 2011
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Neurologist Dr. Shiva Kumar R's  Response
Thanks for the query. You have petit mal epilepsy. Valproate is not good for pregnancy as well as petitmal epilepsy. There are various other kinds of medicines available which don't have any side effects on pregnancy. Your daughter can have a normal baby in the future. Consult a Epilepsy specialist who is experienced in dealing pregnancy and epilepsy and change the medicines. Give your daughter 5 mg of Folic acid from today it self. It is a preventive medicine. Bye

Dr. Shiva Kumar R
Consultant Neurologist & Epileptologist
Answered: Wed, 13 Jul 2011
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