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Epilepsy pre-conception counselling — GPhC CRA MCQ

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ModerateCNS TherapeuticsEpilepsy pre-conception counsellingGPhC CRA

A 30-year-old woman with focal epilepsy presents a new prescription for lamotrigine. Her GP stopped combined oral contraception last month as she is trying to conceive. She asks whether there is anything else she should take before pregnancy. What would you advise the patient?

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Correct answer: B — take folic acid 5mg daily before conception and during early pregnancy

Women with epilepsy who may become pregnant should receive high-dose folic acid before conception and during the first trimester. Lamotrigine should not be stopped abruptly because seizure relapse can harm both mother and fetus. Vitamin D may be relevant for some patients taking antiepileptics, but it does not replace folate. The pharmacist should also encourage specialist pre-conception review.

Reference: BNF; NICE CKS: Epilepsy