Is it safe to take drugs for epilepsy during pregnancy?

Q: I am a 28 years old female, epileptic for the last 13 years. Currently, I am taking Gardinal (Phenobarbitone). I am planning to go the family way and the doctor has asked me to take Levera 250 (Levetiracetam). Please suggest whether it is a right drug to be taken during pregnancy?

A:Nearly all drugs used in the treatment of epilepsy can cause problems during pregnancy. Unfortunately the risk of seizures is more during pregnancy; hence medication is a must. The best course of action is to use the drug with least problems. In rats and rabbits, Levera (levetiracetam) is known to cross the placenta and the concentration of the drug in the fetus is similar to maternal plasma levels. In these species, levetiracetam produced evidence of developmental toxicity at doses similar to or greater than human therapeutic doses. Hence it is better to use Gardenal (phenobarbitone) which is a very old, tried and tested medicine with least adverse effects during pregnancy. However folic acid (Folet) 5mg daily MUST be used daily since Gardenal can reduce folic acid levels.