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Why an anti-epileptic drug (AED) choice in women with epilepsy is important?


  • Women with epilepsy face several unique challenges.1,2
  • These vary by life stage, with women of childbearing age having a particularly complex set of challenges.1
  • Hormonal changes occurring throughout a woman’s life can influence and be influenced by seizure mechanisms and AEDs, presenting unique management challenges.1
  • Management challenges in this population include the higher risk of pregnancy complications than in women without epilepsy.1
  • Awareness of these gender-specific issues and effective interventions in women with epilepsy results in significantly improved health-related quality of life in this patient population.2

This figure has been independently created by GSK from the original data. The same results were first published in Bangar S, et al. Funct Neurol 2016;31(3):

Keppra can be used during pregnancy, if after careful assessment it is considered clinically needed. In such case, the lowest effective dose is recommended. Physiological changes during pregnancy may affect levetiracetam concentration. Decreases in levetiracetam plasma concentrations have been observed during pregnancy and these are more pronounced in the third trimester.4

Keppra was associated with a lower risk of major congenital malformations (MCMs) in infants of women with epilepsy exposed in utero compared with older AEDs, such as CBZ [>700 mg/day]3

Even the lowest doses of VPA (≤650 mg) are associated with a higher risk of MCMs vs Keppra (2.8% Keppra all doses vs 6.3% VPA ≤650 mg, p=0.0069. OR 2.43 [95% CI:1.30–4.55])3

Read more about Keppra


AED: anti-epileptic drug; CBZ: carbamazepine; MCM: major congenital malformations; PCOS: polycystic ovary syndrome; OCP: oral contraceptive pill; VPA: valproate.


  1. Stephen LJ, et al. Lancet Neurol 2019;18(5):481–491.
  2. Bangar S, et al. Funct Neurol 2016;31(3):127–134.
  3. Tomson T, et al. Lancet Neurol 2018;17(6):530–538.
  4. Levetiracetam. Non-Central Data Sheet Version Number: 10. Version Date: 6 January 2020.

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PM-NG-LVT-WCNT-200004 Date of preparation: November 2020.