A-female patint of childbearing age is on valproate for JME. Whichk drug should be used to replace valproate and can be prescribed as montherapy?

It is known to cause serious abnormalities in the baby if taken during pregnancy. Because of this it is not typically recommended in women of childbearing age who have migraines. Common side effects include sleepiness, dizziness, feeling tired, and aggression. Severe side effects may include psychosis, suicide, and allergic reactions such as Stevens-Johnson syndrome and anaphylaxis. It is unclear if use is safe during pregnancy but it appears okay when breastfeeding.It is the S-enantiomer of etiracetam.How it works is not clear Ref Davidson 23rd edition pg 1036 With respect to major congenital malformations (MCM), levetiracetam taken in monotherapy can be considered a safer alternative to valproate for women with epilepsy of childbearing age as per studies Ref Harrison20th edition pg 2345