American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which medication is recommended for treating generalized epilepsy in women of childbearing age?

Phenytoin
Levetiracetam
Carbamazepine
Valproate

The correct answer is: Levetiracetam

Levetiracetam is a preferred choice for treating generalized epilepsy in women of childbearing age due to its favorable profile in terms of potential teratogenic effects and its overall safety during pregnancy. Unlike some other antiepileptic medications, levetiracetam has not been associated with significant risks of birth defects or adverse outcomes, making it a more suitable option for women who may become pregnant or are planning to conceive. In contrast, medications like valproate and carbamazepine have established risks for teratogenic effects, particularly associated with neural tube defects and other developmental issues. Furthermore, while phenytoin may be effective for certain types of seizures, it also carries risks of affecting fetal development if taken during pregnancy. Given these considerations, levetiracetam stands out as a medication that can effectively manage generalized epilepsy while minimizing potential risks to both the patient and the unborn child. This makes it an appropriate recommendation for women of childbearing age needing treatment for epilepsy.