A 22-year-old woman with juvenile myoclonic epilepsy needs initiation of antiseizure therapy. She is planning pregnancy within two years. Which drug should be specifically avoided?
- A Levetiracetam
- B Valproate ✓
- C Lamotrigine
- D Topiramate at low dose
Correct answer: B. Valproate
Explanation
Valproate carries the highest teratogenic risk among antiseizure drugs, causing neural tube defects in roughly 1 to 2 percent of exposed pregnancies, and is also linked to cognitive impairment in the child and polycystic ovarian syndrome. Guidelines advise avoiding it in women of childbearing potential when alternatives exist. Levetiracetam and lamotrigine have comparatively low malformation rates and are preferred in this setting.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.