Morrison C, Rieder M J
Department of Paediatrics and Pharmacology & Toxicology, University of Western Ontario, London, Canada.
Reprod Toxicol. 1993;7(1):55-9. doi: 10.1016/0890-6238(93)90010-5.
The optimal management of epilepsy in epileptic pregnancies remains controversial. We surveyed all neurologists in Canada to determine their usual practice in managing epilepsy during pregnancy. We identified 436 neurologists in the 1990 edition of the Canadian Handbook of Medical and Surgical Specialists. We mailed a questionnaire enquiring with respect to details of management of epilepsy during pregnancy to all neurologists; in the case of nonrespondents, a follow-up questionnaire was mailed eight weeks later. We achieved a 65% response rate. We found that carbamazepine was the antiepileptic drug of first choice for the management of epilepsy during pregnancy among the majority of neurologists (75%), while phenobarbital (10%) and phenytoin (11%) were recommended much less frequently. Eight percent of respondents never used polytherapy during pregnancy. Despite recent controversy over the reproductive safety of carbamazepine, monotherapy with carbamazepine is regarded by the vast majority of Canadian neurologists as the therapy of first choice for epilepsy during pregnancy.
