Pregnancy and drug use in neurological disease

Excerpt

The use of drugs in pregnant women with neurological disease is problematic, not only because of the recognised adverse effects of established medications such as anti-epileptics, but also an understandable maternal anxiety to avoid even the lowest levels of risk when considering the health of an unborn child. The result of this is that mothers and physicians commonly adopt a default position to avoid therapeutic interventions in pregnancy and the pre-conceptual period. However, it remains important that this avoidance is carefully balanced against the risk of the disorder itself and the effects of under treatment for both mother and baby. With little in the way of evidence-based data available to inform clinical decisions, and a paucity of safety data as a result of limited exposure in women of reproductive age, counselling and risk analysis is often problematic and clinical management needs to be carefully tailored to the wishes of individual patients. …