From the Research
I strongly advise against doubling your lamotrigine dose on your own during the third trimester of pregnancy, and instead recommend consulting your neurologist or obstetrician immediately for proper dose adjustment based on your blood levels. Lamotrigine levels should typically be maintained within the therapeutic range of 2.5-15 μg/mL throughout pregnancy 1. During the third trimester, lamotrigine clearance increases significantly (up to 300% in some women), often requiring dose adjustments to maintain seizure control 2. Your doctor will likely order blood tests to check your current lamotrigine level and adjust your dose accordingly. Self-adjusting medication can lead to toxicity or breakthrough seizures, both of which pose risks to you and your baby. Some key points to consider:
- Lamotrigine has a low teratogenic potential, making it a suitable option for women with epilepsy during pregnancy 1
- Folic acid supplementation is recommended to reduce the risk of major congenital malformations 3, 1
- Levetiracetam may be a good alternative to lamotrigine, with a low malformation rate and effective seizure control during pregnancy 2
- Pregnancy hormones and increased blood volume affect how your body processes lamotrigine, requiring careful management and monitoring 4, 5 Your healthcare provider may recommend more frequent monitoring (every 4 weeks) during the third trimester and will create a plan to gradually reduce your dose after delivery, as lamotrigine levels can rise quickly postpartum. This careful management is necessary to ensure the best possible outcome for both you and your baby.