Patient of juvenile myoclonic epilepsy on valproate comes to you at 5 months of pregnancy with level H scan normal what will you advise?
Ans. is 'b' i.e., Continue the drug in same dose Valproic acid has the risk of fetal malformations during the first trimester of pregnancy. This patient has normal level II scan at 5 months of pregnancy so the risk period of valproate is already over and valproate is the drug of choice in juvenile myoclonic epilepsy. Thus the drug shoud be continued in the same doses.
Change the drug
Continue the drug in same dose
Decrease the dose of drug
Increase the dose of drug