A 28-year-old couple attends the GP for pre-conception advice. The female partner has well-controlled epilepsy on lamotrigine. She asks about the impa...

Question

A 28-year-old couple attends the GP for pre-conception advice. The female partner has well-controlled epilepsy on lamotrigine. She asks about the impact of lamotrigine on fertility and pregnancy. Which is the most important pre-conception action?

Accepted Answer

Ensure she is taking high-dose folic acid (5 mg daily) and refer for pre-pregnancy counselling with neurology, as lamotrigine doses may need adjustment during pregnancy

Answer

Switch lamotrigine to sodium valproate for better seizure control before conception

Answer

Lamotrigine is safe in pregnancy - no special precautions are needed

Answer

Stop all antiepileptic drugs before conception

Answer

Switch to carbamazepine

uk-drcog MCQ (SBA): Pre-conception Counselling with Lamotrigine

A 28-year-old couple attends the GP for pre-conception advice. The female partner has well-controlled epilepsy on lamotrigine. She asks about the impact of lamotrigine on fertility and pregnancy. Which is the most important pre-conception action?