The efficacy of antiseizure medicines (ASMs) is not thought to differ in males and females. As such, this recommendation builds on EPI3 and focuses on the medicines that are now being preferentially recommended as therapeutic options.
In women and girls with epilepsy who are of childbearing potential, lamotrigine or levetiracetam should be offered as first-line monotherapy for both generalized onset seizures and focal onset seizures.
Women with epilepsy should have seizures controlled as well as possible with the minimum dose of ASMs taken in monotherapy, wherever possible. Valproic acid (sodium valproate) is not recommended in women and girls of childbearing potential because of potential harm to the fetus.
Strength of recommendation: STRONG
Certainty of evidence: VERY LOW

Standard breastfeeding recommendations remain appropriate for women with epilepsy taking the ASMs included in this review (phenobarbital, phenytoin, valproic acid [sodium valproate], carbamazepine, lamotrigine, levetiracetam, topiramate, lacosamide).
Strength of recommendation: STRONG
Certainty of evidence: VERY LOW

2012 validated

Folic acid should routinely be taken by women with epilepsy of childbearing age who are on antiseizure medicines.
Strength of recommendation: STRONG
Certainty of evidence: VERY LOW