I am 3 months pregnant and I take 200mg of tegretol 3 times a day. It controls my seizures so I have to take it. I only take tegretol. I've been taking 1200mcg of folic acid a day. Is this enough or too much?

Not sure if that's too much but you are supposed to take 400mcg of folic acid

Tegretol is okay to take during pregnancy, but you are taking way too much folic acid. Most of the folic acid we need, we get in our diet, also, if you are taking prenatal vitamins (and you should be) they contain the added folic acid that you may not be getting in your diet.

Please cut back on the folic acid as it is not doing anything for you, as a matter of fact, it is a waste of money because what your body does not need you lose the rest in your urine.

I MUST recant what I said above. After Willow brought her research to my attention in a PM, I did a little more research on my own.

Tegretol is a Category (D) in pregnancy and therefore should be avoided at all costs unless there is no other medication that the patient can use to control seizures.

I feel terrible that I made the callous mistake.

I have recommended that she see a high risk OB (if she is not already) that may be aware of better medications for her condition. I have also suggested that she continue to take the higher amount of folic acid since Tegretol is known to possibly cause Neural Tube defects in neonates, Spina Bifida is one.

I hope Joe chimes in on this one since he has first-hand knowledge of the condition that Willow suffers from.

Again, I apologize for my terrible mistake.

My wife has epilepsy and she had to take dilantin while she was pregnant. Dilantin is considered category d as well. The neurologist gave a prescription of 5 mg of folic acid which is the same as 500 mcg. She was also taking a prenatel which has 1 more mg of folic acid.
She was taking 6mg of folic acid through out her whole pregnancy. Pharmacists, doctors and neurologists have different take on dealing with this.

My wife's friend has epilepsy and she was taking tegretol she was taking 300 mg of tegretol I think twice a day. Not sure. She had seen so many different doctors and each doctor said something different. One doctor was telling her that 1mg of folic acid was enough for her. Meanwhile my wife was telling her to take 6 altogether.

The worst advice anybody could give to somebody is to stop taking medication, especially somebody that does not know much about seizures or epilepsy. We had one women OB, before our planning to have a baby that she needs to stop all her medications and if there is anything wrong with the baby that there is abortion. Lets just say we never went back.
My wife's neurologist said the old way of thinking, the earlier days they frowned on epileptic women getting pregnant. There is no reason why epileptic women can not get pregnant. There is lots of support out there for pregnancy.

The regular population risk for deformaties in pregnancy is 2 to 3 percent.
With epilepsy and while on medication the risk increases to 4 to 6 percent.

Each individual case is different, but the 5 mg and prenatel taking it before pregnancy is important. I think there is evidence that both dilantin and tegretol cross the placental so the baby does take in the medication.

Always to be considered a risk. Have to weigh the risks of not taking the medicine at all during pregnancy or the risk possible do to taking the medicine. The risks to the fetus of having uncontrolled epilepsy do to not taking the medicine out weigh the risks of actually taken the medication during pregnancy. The damage to the unborn fetus because of having seizures.

Now there is even evidence that suggest the need to increase medication doses during pregnancy and also having more seizures are possible.

Also you mentioned that your only on one medication which is good. The risks increase if taking two because many epileptic women have two medications to control their seizures. My wife was on two until the neurologist found out our plans to get pregnancy so we had to get her down to one.

For my wife, her medication was increased to 600 mg per day of dilantin. She started at 400 mg. 6 months pregnant she had a grand mal seizure because her levels dropped to low.

What is important is close monitoring of blood levels of medication. Probably more ultrasound scans just to make sure the baby is developing fine.

I have heard many many stories of epileptic women have medicine while pregnant and there babies are fine, but then there are some that are at risk of having developemental delay, spina bifida, cleft lip and no palat. These are all possibilities even without any health conditions.

If you have any family history of deformaties then that would explain the high dose of folic acid but I would not be taking 1200 mcg which equals to 12 mg. I would say the most would be 8. Even with that said. Most sites and information I get recommend 4. Up to 8 with diabetes and epilepsy or family history of deformaty complications.

There is so so much on this information but please do not stop taking your epileptic medicine. That is suicide for you and the baby. You need to keep calm and stress free as possible. Eat healthy, take your prenatel and folic acid but you need to decide what is a comfortable amount for you to take because quite honestly it sounds like you are not. So I would reduce it to at least 600 mcg or 800 mcg the most. Not 1200 mcg. That is just from opinion and experience. Although dilantin and tegretol are different medications.

I hope that you see a neurologist, ob and family doctor.

It is important that you get referred to high risk care, because this is considered an high risk pregnancy. You need to be aware of everything and also be in charge of your care. My wife did not see a high risk doctors until 6 months after the seizure that is when our doctor did not feel comfortable to continue with her care.

I need to end this but I just wanted to chime in and I hope this helps you.

You are right in the advice given to you about continuing your medication and also only being on one.

Best of luck during your pregnancy. Just to let you know my wife and I now have a beautiful super baby that is 7 months old right now. He is doing well.

My wife's friend has a beautiful girl and I think she is a year old now. They are amazing to have.

If you have anymore questions. Please feel free to ask.

Joe

Oh, I forgot it all depends on the frequency and how strong the seizures are. There are so many factors that go into the doctors decisions and patients decisions as well.

I would also like to add that some doctors recommend this and some do not. The last month of pregnancy, taking vitamin k. It is prescribed and can be taken orally mixed in orangejuice. The think with this medication is too much is not good and it is a theory that this will help the blood clotting in babies with mothers taken epileptic medications. We were given our prescription but we did not take as much but took it occasionally. Our thought was too much of any vitamin is not good. We followed our own concience and our own thinking in what was important and what was not.

Joe