Pregnant Women Should Avoid Epilepsy Drug Valproate, Experts Say

The anti-seizure drug Valproate should not be taken by epileptic women during pregnancy because it may lead to major birth defects and lower IQ in children, two leading medical groups say.

Valproate is the brand name of the generic drug depakote made by Abbott. It has been prescribed to prevent seizures in women during pregnancy. An estimated 500,000 women of childbearing age in the United States have epilepsy and three to five of every 1,000 births are to women with epilepsy, officials say.

Under new guidelines just unveiled by the American Academy of Neurology and the American Epilepsy Society, women are advised to stay off Valproate during their pregnancies to avoid severe and permanent damage to their babies.

“There is good evidence that valproate, whether used by itself or in combination with other medications, increases the risk of major birth defects, including cleft palate and spinal bifida,” says guideline co-author Gary S. Gronseth, MD, vice chairman of neurology at the University of Kansas Medical Center in Kansas City.

Lower IQ Noted in Separate Study

The new guidelines come in a tough month for Abbott and its popular anti-seizure drug. Just last week, another medical study found that children born to women who took Valproate during their pregnancies had, on average, IQ at age 3 that was as much as nine points lower than scores of children whose mothers did not take the drug during pregnancy.

An Abbott spokesperson said Valproate is not an effective medication for all women and that doctors and patients should discuss their treatment options, including the risks and benefits.

Guidelines Offer Other Recommendations

The medical experts offered other recommendations for epileptic women during pregnancy. They include:

• Women with epilepsy should, if possible, avoid taking more than one epilepsy drug at a time during pregnancy, since doing so can raise the risk of birth defects compared with taking only one medication.

• Pregnant women with epilepsy should have their blood tested regularly, as doing so can help detect problems and avoid seizures.

• Women who plan to become pregnant should take at least 400 micrograms of folic acid a day. This has been proven effective in helping prevent major birth defects.

• Smoking during pregnancy should be avoided, since it can increase substantially the risk of premature contractions and premature labor and delivery during pregnancy.

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