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Unfortunately, many patients with epilepsy fail their first trial of an anti-seizure medication. A large proportion of these patients are put on a second agent...or a third. But is more necessarily better? Produced by James E. Siegler. Music by Justin Warren and Lee Rosevere. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. REFERENCES Perucca E. Clinically relevant drug interactions with antiepileptic drugs. Br J Clin Pharmacol. 2006;61:246-255 Pennell PB, Newport DJ, Stowe ZN, Helmers SL, Montgomery JQ, Henry TR. The impact of pregnancy and childbirth on the metabolism of lamotrigine. Neurology. 2004;62:292-295 Petrenaite V, Sabers A, Hansen-Schwartz J. Individual changes in lamotrigine plasma concentrations during pregnancy. Epilepsy Res. 2005;65:185-188 Pennell PB, Peng L, Newport DJ, Ritchie JC, Koganti A, Holley DK, et al. Lamotrigine in pregnancy: Clearance, therapeutic drug monitoring, and seizure frequency. Neurology. 2008;70:2130-2136