Revolutionizing Epilepsy Care: New Research Empowers Pregnant Women with Medication Adjustments
A groundbreaking study has emerged, offering a beacon of hope for pregnant women with epilepsy. This research equips doctors with evidence-based strategies to adjust medication doses, ensuring optimal care during pregnancy and postpartum. Published in Neurology in January 2026, the study analyzed dosing changes made in pregnant and postpartum women in the US between 2012-2016.
Dr. Page Pennell and her team utilized data from the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) initiative. Their goal was to provide practical evidence, empowering healthcare professionals worldwide to deliver the best care for women with epilepsy during pregnancy.
The findings are particularly crucial, as the MBRRACE report, published in 2025, revealed alarming statistics. Epilepsy and stroke were among the top five leading causes of maternal death between 2021-2023. Additionally, a 2023 MBRRACE report highlighted a disturbing trend: deaths from sudden unexpected death in epilepsy (SUDEP) in mothers with epilepsy had doubled between 2013-2015 and 2019-2021.
Epilepsy Action emphasizes the heightened risk of death during pregnancy or the 12 months post-birth for individuals with epilepsy compared to those without. The study, involving 299 women aged 14-45, revealed insightful medication adjustments.
Approximately two-thirds of epilepsy medications were increased during pregnancy, with nearly half being decreased post-birth. Lamotrigine doses were significantly increased in nearly 90% of cases, reaching nearly double the original dose. By six weeks postpartum, most women had their doses reduced to just over the original amount.
Levetiracetam doses saw a similar pattern, with over half being increased during pregnancy, reaching 177% of the original dose. Around a third had their doses reduced to approximately 136% of the original post-birth.
The researchers concluded that these medication management strategies are key to the success of previous MONEAD studies, showing no difference in seizure control between pregnant and non-pregnant groups. They emphasized the potential for these findings to guide the management of pregnant women with epilepsy.
Tom Shillito, health improvement and research manager at Epilepsy Action, underscores the importance of careful epilepsy management during pregnancy. He highlights how body changes can impact medication effectiveness, emphasizing the vital role of regular monitoring and adjustments in ensuring women's safety. Epilepsy Action has been collaborating with healthcare professionals and individuals with epilepsy to develop comprehensive guidance, supporting the delivery of the best care for pregnant women with epilepsy.
This research marks a significant step forward in empowering pregnant women with epilepsy, offering a roadmap for safe and effective medication management.
