Baseline dosing outshines serum levels for predicting seizures in pregnancy.
Predicting seizure risk in pregnant women with epilepsy is crucial for managing treatment and maintaining safety. Serial measurement of lamotrigine concentrations did not improve seizure prediction, with baseline lamotrigine dose being a better predictor (HR 1.005, 95% CI 1.003 to 1.007). Routine serial monitoring of lamotrigine levels in pregnancy may not be necessary for seizure prediction. Focus on baseline dosing may be more effective. Baseline lamotrigine dose predicts seizure risk better than serum concentration monitoring in pregnancy.
Authors: Allotey J, Junaid F, Peréz T, Rolle V, Pardo MDC, Zamora J, Thangaratinam S
Citation: Allotey J, Junaid F, Peréz T, et al. Lamotrigine serum concentrations as longitudinal biomarkers for seizure risk prediction in pregnant women with epilepsy: a secondary analysis of the EMPiRE study. BMJ neurology open. 2026;8(1):e001547. doi:10.1136/bmjno-2026-001547
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