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April 27, 2009
Antiseizure drug impairs fetal brain development

By Quinn Eastman

Three-year-olds whose mothers took the antiepileptic drug valproate during pregnancy had average IQs 6–9 points lower than children exposed to three other antiepileptic drugs, a landmark multicenter study has found.
The Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study’s authors say that women of childbearing age should avoid valproate as a first choice drug for the treatment of epilepsy. The results were published in the April 16 issue of the New England Journal of Medicine.

“Valproate still has an important role in treating epilepsy, because some patients’ seizures can only be controlled with valproate,” says lead author and Emory neurologist Kimford Meador. “However, we are recommending that women with epilepsy try another drug first.”

Meador stressed that women who are pregnant and take valproate should not stop without consulting a physician, to avoid seizures with potentially serious consequences.

Valproate is also prescribed for bipolar disorder and migraine headaches. It is sold under the brand name Depakote. Last year the FDA approved a generic version.

The NEAD study is following more than 300 children born to women with epilepsy between 1999 and 2004. At enrollment, the women were taking a single antiepileptic agent: carbamazepine, lamotrigine, phenytoin or valproate.

The NEAD study previously found that valproate exposure also increases the risk of anatomical birth defects.