tegratol

[Little T]

I am 23 years old and was diagnosed with Epilepsy when I was 14.  I have been taking depakote ever since and have had no seizures.  My doctor tried to take me off Depakote when I was 17; however, about after a week of being off I had a seizure and he put me back on it.  At this point my husband and I are ready to have children.  My doctor has advised me that Depakote is not the safest choice and has advised tegratol.  My question is, will tegratol control juvenile myoclonic seizures and what kind of birth defects could tegratol cause.  Also, where can I find some good information on different types of medicines and their effects on the fetus?  i have been doing a lot of research and it is all very confusing.

[CCF-Neuro-M.D.-JT]

This is a very common and complex situation that we are faced with in neurology. Unfortunately, just about every antiepileptic drug (if not all) is teratogenic has been known to cause fetal malformations, including depakote and tegretol. In one study,  Depakote (the most teratogenic sz med)carried a 6% risk of  major malformations and tegretol (the second most teratogenic) carried a 4% risk. On the other hand, not taking the meds runs the risk of birth and pregnancy complications due to the seizures themselves.

The American Epilepsy society's guideline regarding this is that the best medication for the epilepsy be used. In your particular case, there is a medication called Lamictal that we feel is better than tegretol at treating juvenile myoclonic epilepsy and in animal studies has not been shown to carry significant risk of malformation. For more info, contact The Epilepsy FOudnation at www.efa.org. Good luck and talk to your doctor. ANd don't forget to take folate!

[headproblemz]

Tegretol, accroding to my knowledge, is generally for generalized tonic-clonic seizures and complex-partial seizures. I don't believe that it is used that much for treating myoclonic seizures.

Best regards,
***headproblemz***