A 32-year-old woman with generalized tonic-clonic seizures controlled on lamotrigine for 3 years presents planning pregnancy. Vital signs are normal (BP 118/76, HR 72, RR 16, Temp 37°C). Recent serum lamotrigine level is therapeutic at 12 mcg/mL. She denies breakthrough seizures and medication non-compliance. She expresses concern about teratogenic effects and requests counseling regarding medication safety in pregnancy. Which of the following is the most accurate counsel?

1. A)Switch to valproic acid, which is the safest AED in pregnancy
2. B)Continue lamotrigine but increase the dose by 50% due to increased clearance in pregnancy
3. C)Stop all antiepileptic drugs immediately to avoid teratogenicity
4. D)Continue current monotherapy; lamotrigine has low teratogenic potential and the risk of seizures outweighs medication riskGABARITO
5. E)Switch to phenytoin to reduce the risk of cleft palate