Abstracts

It is policy in our pregnancy and epilepsy clinic (about 100 deliveries a year) to suggest that post delivery, all women who were taking anticonvulsants at birth, breast feed (at least some of the time) for at least 4 days after delivery to prevent sudden withdrawal of the anticonvulsant from the baby at birth (the colostrum period) unless the baby is significantly premature. An increasing number of pregnant women in our clinic are taking levetiracetam either in combination with another anticonvulsant or as monotherapy. Levetiracetam is a new antiepileptic drug (AED) shown to be effective and well tolerated. However, there are still insufficient data on its use in pregnant and lactating women and so some midwives are reluctant to suggest advising the policy of breast feeding with levetiracetam because its concentration in breast milk is currently unknown.
We aimed therefore, to assess the levels of levetiracetam in breast milk post delivery. We have therefore been trying to measure breast milk levels of levetiracetam at 4 days post delivery and 2-3 months post delivery in those mothers who continue to breast feed. Because stay in hospital is usually short this is not as easy as it sounds but we now have data on 12 women. The evidence so far is that breast milk levels of levetiracetam are significantly lower than blood levels in the mother. Our results suggest that it is safe for women taking levetiracetam during their pregnancy and the puerperium to breast feed with this drug, particularly because there have been no concomitant clinical problems. (Supported by Educational Grant from UCB Pharma, UK.)