Abstract
Patients with epilepsy require long-term treatment with antiepileptic drugs (AEDs), and in female patients the management of epilepsy before, during, and after pregnancy is critical. Pregnancy is associated with pharmacokinetic changes, including increased volume of distribution, elevated renal clearance, and induction of drug-metabolizing enzymes (cytochrome p450 [CYP] family and uridine diphosphate glucuronosyltransferase [UGTs]). For example, the concentrations of lamotrigine, which is metabolized in the liver by UGTs, and levetiracetam, which is primarily eliminated by renal excretion, can decrease by 40% to 80% during pregnancy.
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