New research has provided practical, evidence-based strategies for adjusting anti-seizure medication doses in pregnant women with epilepsy, offering clinicians new guidance to help maintain seizure control during pregnancy and the postnatal period.
Published in Neurology in January 2026, the study analysed data from the Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study, examining medication dose changes and seizure outcomes in women with epilepsy during pregnancy and up to six weeks after birth.
Researchers found that medication adjustments during pregnancy were common and often necessary. Overall, nearly 68% of anti-seizure medications required dose increases during pregnancy, while almost half were reduced again after delivery.
Key findings from the study included:
- Nearly 68% of anti-seizure medications required dose increases during pregnancy.
- Almost half of medications were reduced again after childbirth.
- Women taking lamotrigine required dose increases in almost 88% of cases, reaching an average of 191% of their pre-pregnancy dose.
- More than half (56%) of women taking levetiracetam required dose increases, reaching an average of 177% of their original dose.
Lead researcher Dr Page Pennell said the findings provide "practical evidence" that can be applied immediately in clinical practice to support women with epilepsy throughout pregnancy.
The researchers concluded that these medication management strategies may explain why previous MONEAD studies found no significant difference in seizure control between pregnant and non-pregnant women with epilepsy.
The findings come amid continued concern around maternal outcomes in women with epilepsy. The 2025 MBRRACE report identified epilepsy and stroke among the top five leading causes of maternal death between 2021 and 2023.
Tom Shillito, Health Improvement and Research Manager at Epilepsy Action, said the research highlights the importance of carefully managing epilepsy during pregnancy, noting that changes in the body can affect how anti-seizure medications work and that regular monitoring and dose adjustments can play a vital role in keeping women safe.
Source: Epilepsy Action
Looking to improve care for women with epilepsy during pregnancy?
Join us for our upcoming virtual CPD conference Improving Care for Women with Epilepsy in Pregnancy: Delivering Element 3 of the Maternal Care Bundle taking place on Friday 25 September 2026.
This conference focuses on developing your skills and competence in supporting women with epilepsy in pregnancy, and on delivering Element 3 of the National Maternal Care Bundle.
To find out more and book your place visit: www.healthcareconferencesuk.co.uk/virtual-online-courses/epilepsy-in-pregnancy
