Prescribing Safety Assessment (PSA) Practice Exam

For women suffering from tonic seizures, which antiepileptic drug is preferred?

1. Valproate

2. Carbamazepine

3. Lamotrigine

4. Phenytoin

The correct answer is: Lamotrigine

In the context of treating women suffering from tonic seizures, lamotrigine is preferred due to its favorable profile regarding both efficacy and safety, particularly in relation to reproductive health and pregnancy. Lamotrigine is known to have a lower risk of teratogenicity compared to some other antiepileptic medications, making it a more suitable option for women, especially those who may become pregnant or are of childbearing age. Valproate is effective for various seizure types but is associated with a higher risk of congenital malformations and developmental disorders when taken during pregnancy. It is therefore often avoided in women of childbearing age unless absolutely necessary. Carbamazepine has a lower risk of teratogenic effects compared to valproate; however, it is still associated with an increased risk of certain adverse outcomes during pregnancy. Phenytoin is also less favorable due to its association with fetal hydantoin syndrome and other potential risks during pregnancy. Overall, lamotrigine strikes a balance between adequate control of tonic seizures and a more acceptable safety profile for women, particularly those who are pregnant or planning to conceive. This makes it the preferred choice in this scenario.