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Antiepileptic drug management in pregnancy (EMPiRE)

Antiepileptic drug (AED) management in pregnancy: an evaluation of effectiveness, cost effectiveness, and acceptability of dose adjustment strategies (EMPiRE)

EMPiRE is a study on the management of anti-epileptic drugs (AEDs) for women with epilepsy who are pregnant.

When a woman with epilepsy is pregnant, it is important that her doctor considers such issues as:

  • choice of AEDs, 
  • risk of seizures to her and the baby while pregnant, 
  • risk of any anti-epileptic drugs to unborn child, and 
  • the increased monitoring and attendance at maternity clinics.

Both seizures during pregnancy and the effects of anti-epileptic drugs are thought to affect children born to mothers with epilepsy.

There is very little research on the type of care and treatment that is beneficial to the mother and baby. Therefore, doctors may find it difficult to reliably advise on the best way to treat and manage such patients during this time. Doctors are responsible for reducing the risk of seizure while ensuring that the drugs do not affect the developing baby.

The research team carrying out the study is led by Professor Khalid Khan from Queen Mary University, London. The study is funded by the National Institute for Health Research Health Technology Assessment Programme

Epilepsy Action is delighted to support such an important research study. Acting as a stakeholder, we will help promote and publish information about Empire in our magazines, website and through our local events.

There is more information on the EMPIRE website or you may contact Julie Dodds, j.dodds@qmul.ac.uk

Read the EMPiRE blog


  • This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme (project number 09/55/38) and will be published in full in Health Technology Assessment.
  • The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.

Comments: read the 2 comments or add yours


what is the choice of antiepileptic in pregnant women?
atleast a drug with fewer side effects?

Submitted by rumana hameed on

Hi Rumana

Thanks for your message. Most women with epilepsy can continue to take their epilepsy medicine during pregnancy and have healthy pregnancies and healthy babies. Some epilepsy medicines have been shown to carry a small risk of birth problems, so it’s important to get advice from an epilepsy specialist before trying for a baby. This way the specialist can make sure you are on the safest treatment option for you and the baby. If you are in the UK you might be able to have pre-conception counselling before you start trying for a baby. You can ask your family doctor or epilepsy specialist or nurse to arrange this for you. If you are already pregnant speak to your family doctor as soon as possible. They should be able to make sure you get the help and advice you need.

The amount of evidence about the risks of epilepsy medicines in pregnancy varies. Usually the medicines which have been around for longer have had more research into them. You might find it helps to read our information about epilepsy medicines and pregnancy. This includes a table which compares the risk of birth problems with some of the epilepsy medicines. Research has shown that sodium valproate (Epilim) carries the greatest risk, so it’s recommended that women of child-bearing age don’t take this unless there’s no safer alternative. Of the newer medicines available, there has been some research into levetiracetam (Keppra). This research has shown that levetiracetam appears to be one of the safer medicines to take during pregnancy.

If you are worried about side effects for you, all medicines can cause side effects. The risk of side effects varies from medicine to medicine and person to person, so it’s best to discuss any worries you have with your epilepsy specialist. You might also find it helps to read our information about side effects.

I hope this information is useful. We’ve also got lots of information on our website about epilepsy and having a baby. If you have any further questions please feel free to get in touch.


Epilepsy Action Advice and Information Team


Submitted by Grace, Epilepsy... on

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