What risks do epilepsy drugs present to fetuses?

There is a rather effective drug for treating epilepsy called Topiramate. The problem is, while it is quite effective at suppressing epileptic fits, in pregnant women it increases the chances that a baby will be born with a cleft lip by twelvefold.

But that is not the quandary, because cleft lip surgery on babies is quite effective. The quandary is the very high fetus/mother death rate that results when women have an epileptic seizure while pregnant. Doctors have been criticized for continuing to prescribe Topiramate after more than one study concluded that the drug had risks to the fetus.

Doctors argue that a cleft lip newborn is better than a dead newborn with a dead mom. Listen to the story from BBC Radio on the player below.



Topiramate is also prescribed to treat migraines, bi-polar disorder and even as a weight loss drug. In pregnant women who take the drug for migraines or bi-polar disorder, there is no significant increase to the fetus of being born with cleft lip like there is with pregnant women taking the drug for epilepsy. Scientists think this might have to do with the difference in dosages used to treat the various health issues.