Pregnancy and epilepsy: pharmacokinetic insights into antiseizure medications. Expert Opin Drug Metab Toxicol 2026 Apr;22(4):251-265
Date
03/22/2026Pubmed ID
41863508DOI
10.1080/17425255.2026.2650186Scopus ID
2-s2.0-105034777693 (requires institutional sign-in at Scopus site)Abstract
INTRODUCTION: Absorption, distribution, metabolism and excretion of antiseizure medications may undergo significant modifications throughout pregnancy. These necessitate careful and proactive monitoring to avoid breakthrough seizures during pregnancy with potentially lethal consequences for both mother and child.
AREAS COVERED: Based on the available literature, pharmacokinetics of both older and newer antiseizure medications are examined by the authors, emphasizing the important available data and the missing ones for which it is necessary to expand knowledge.
EXPERT OPINION: Therapeutic drug monitoring is a valuable tool for tailoring antiseizure treatment in women with epilepsy. When monitoring is not feasible, clinicians may need to adjust doses based on seizure severity and the well-documented pharmacokinetic changes of specific medications such as lamotrigine, levetiracetam, oxcarbazepine. The goal is to maintain effective seizure control while minimizing teratogenic risks and ensuring safe fetal development.
Author List
Falcicchio G, Nucera B, Giuliano L, Castellucci G, Colonna I, Russo EAuthor
Giovanni Castellucci MS, MD Instructor in the Neurology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AnimalsAnticonvulsants
Dose-Response Relationship, Drug
Drug Monitoring
Epilepsy
Female
Fetal Development
Humans
Pregnancy
Pregnancy Complications
Severity of Illness Index
