Safety and Tolerability of Antiepileptic Drugs in Women with Epilepsy: Literature Review and Own Data

The literature review and retrospective analysis conducted at the Svt. Luka’s Institute of Child Neurology and Epilepsy focused on the safety and tolerability of antiepileptic drugs (AEDs) in 345 female patients with epilepsy, aged 15 to 40, between 2000 and 2018. The study found that 18.8% of these patients developed significant neuroendocrine reproductive and cosmetic disorders, such as menstrual irregularities, infertility, obesity, hirsutism, and hair loss, which negatively impacted their quality of life. Additionally, adverse pregnancy outcomes were observed in 14.2% of the 70 pregnancies. Valproic acid was identified as having the highest teratogenic potential and was most commonly associated with neuroendocrine reproductive disorders. Carbamazepine was the second most common AED linked to teratogenic effects and reproductive issues. Conversely, newer AEDs like oxcarbazepine, topiramate, and levetiracetam showed the most favorable results. Despite these findings, the majority of women in the study successfully gave birth to healthy children, indicating that pregnancy outcomes are influenced by various factors, including the type of AED used.