<prompt> A 4 month pregnant lady on treatment with valproate regularly asked for your advice regarding taking the drug during pregnancy. What is the best course of actionImmediately tape off valproate and sta lamotrigineChange to carbamazepineContinue valproate and monitor blood levelsSlowly tape dose of valproate  <response>: K.D Tripathy essentials of medical pharmacology 7th edition . Valproate used during pregnancy produced spina bifida and other neural tube defects in off spring:should be avoided Incidence of minor foetal malformation repoed with carbamazepine 