Pregnant woman is on valproate for juvenile myoclonic epilepsy. Alternative monotherapy of choice:

Ref: Lecture Notes: Clinical Pharmacology and Therapeutics, Gerard A. McKay, 8th edition, Page 90 and Atlas of Epilepsies, Volume 3, C. P. Panayiotopoulos et al., Page 1039Explanation:"The largest studies have confirmed sodium valproate as the first choice for generalized epilepsies such as juvenile myoclonic epilepsy (JME). hut where future pregnancy is a possibility. Ixunotrigine is an alternative. Levetiracetam is increasingly usedin such patients without the same level of evidence of safety in pregnancy. " Ref: Lecture Notes: Clinical Pharmacology and TherapeuticsMANAGEMENT OF JMEThe most effective drug in Men is Sodium Valproate.Sodium valproate monotherapy achieves control in 85% patients at 1-2 g daily.Clonazepam is tried in refractory myoclonic jerks.Levetiracetam is approved as adjunctive therapy in JME.Levetiracetam is safer in women of childbearing age and pregnancy.