New antiepileptic drugs and women

•The available literature on new antiepileptic drugs and women is reviewed.•New AEDs may affect female sex hormones and be affected by them.•Those AEDs that have been studied show lower serum concentrations during pregnancy.•Breastfeeding seems to be safe with new AEDs.•Women-specific aspects are insufficiently studied in most new AEDs.

Since 1990, sixteen new antiepileptic drugs (AEDs) have been introduced. Most of these new AEDs have only been insufficiently studied with respect to women-specific aspects such as endogenous sex hormones, hormonal contraception, pregnancy, breastfeeding, or menopause. This is of concern because it has been shown for some of the new AEDs that these factors may have a clinically significant impact on their pharmacokinetics and seizure control. Also, new AEDs may affect hormone homeostasis and pass over into breast milk. The best studied of the new AEDs are lamotrigine, levetiracetam and oxcarbazepine. Although gabapentin and pregabalin are even more frequently used (due to their therapeutic effects in nonepileptic conditions), our understanding of these two drugs in relation to women's issues is surprisingly poor. Little to nothing is known about zonisamide, retigabine/ezogabine, lacosamide, perampanel and the other new AEDs. Nevertheless, many small studies and case series have been published on new AEDs and women-specific aspects. This review gives an overview on what is known today.