A 4 month pregnant lady on treatment with valproate regularly asked for your advice regarding taking the drug during pregnancy. What is the best course of action
K.D Tripathy essentials of medical pharmacology 7th edition . *Valproate used during pregnancy produced spina bifida and other neural tube defects in off spring:should be avoided *Incidence of minor foetal malformation repoed with carbamazepine *
Immediately tape off valproate and sta lamotrigine
Change to carbamazepine
Continue valproate and monitor blood levels
Slowly tape dose of valproate
C.N.S