Epilepsy and pregnancy

Nowadays having epilepsy is no longer usually a reason not to have children of your own. Most expectant mothers with epilepsy progress through pregnancy largely without problem.

Important note: It is important to discuss starting a family with your neurologist well in advance, if possible two years before a planned pregnancy. This is particularly relevant to girls and young women taking valproate (trade names include Depakine and Orfiril), and probably also for topiramate. – See the base of this page for more information regarding valproate.

Women of child-bearing age who are on anti-seizure medication should take folic acid regularly in consultation with their doctor – at the latest when they start trying for a baby, and definitely prior to conception. In the light of recent research, the Epilepsy League recommends a dose of 1-3 mg per day. Higher doses can be considered on an individual basis, depending on the mother’s folate blood level or ethrocyte test results. This could be the case for expectant mothers who are on powerful enzyme-inducing medicines.

As contraceptives can interact with anti-epileptic drugs, women should also consult their neurologist if they need to take them.

Info video “Epilepsy and pregnancy”

Most women with epilepsy can have children without complications – but must plan ahead.

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Apart from a few rare exceptions, epilepsies are not inherited disorders.

If several family members have epilepsy or a person suspects they may have an inherited form of epilepsy then it may be worth undertaking genetic testing.

If taken by the mother during pregnancy, valproate causes abnormalities (e.g. spina bifida) in around 10 percent of infants. It also causes developmental problems (lower than average intelligence, autism) in around 30 to 40% of children whose mothers took valproate while pregnant.

The medication containing the active ingredient valproic acid or valproate is available in Switzerland under the trade names Depakine Chrono, Orfiril, Convulex, Valproat Chrono Desitin retard, Valproat Sandoz retard and Valproate Chrono Zentiva.

If someone is already taking valproate and wants to become pregnant or is pregnant already, they must not under any circumstances stop taking their medication without medical advice – a fall during a seizure could be more dangerous to the unborn child and the mother than the side effects of the drug. Patients who fall into the above categories should urgently consult the neurologist who is treating them.

Our advice to doctors and epilepsy patients: We recommend that girls and women of childbearing age do not start or continue treatment with valproate. Only if no other alternative is effective can there be a case for taking valproate.

Information by Swissmedic (French/German)

Flyer “Epilepsy and Pregnancy”

Important note: The information flyer still recommends taking 4-5 mg of folic acid daily. The Epilepsy League now recommends a dose of 1-3 mg per day. 

Authors: Günter Krämer, Stephan Rüegg, Barbara Tettenborn; last updated: August 2023.