UW obs question

[Greyhame]

This one concerns use of valproate in pregnancy. UW says that a patient of bipolar disorder on a stable valproate dose should be switched to a drug less teratogenic. Does the same principle apply to epilepsy patients on valproate who become pregnant?
Because I remember reading that you maintain epileptic patients on the lowest effective dose of the same drug instead of initiating a new drug which could cause seizure relapse. Can anyone shed some light on this?

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[Reperfused]

As far as I know, for both epilepsy and bipolar (manic episodes), valproate is category D but even for these two conditions, it should be given to a pregnant woman only if all other medications have failed to control the symptoms.
For all other conditions, valproate is category X. Absolutely contraindicated in pregnancy. Like for migraine etc.

Please correct me if I’m wrong.

 

[TheBoneDoctah]

This one concerns use of valproate in pregnancy. UW says that a patient of bipolar disorder on a stable valproate dose should be switched to a drug less teratogenic. Does the same principle apply to epilepsy patients on valproate who become pregnant?
Because I remember reading that you maintain epileptic patients on the lowest effective dose of the same drug instead of initiating a new drug which could cause seizure relapse. Can anyone shed some light on this?

I'd say you place both patients on Lamotrigine.