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Avoid Valproate in Fertile Women

KEY POINT

Valproate should not be prescribed as first-line therapy for any indication (epilepsy, migraine, mood disorder) in women of childbearing age because of a significantly increased risk of major fetal malformations in exposed infants.

SOURCES

Epilepsy Society 58th Annual Meeting abstracts (not available online at press time).

Adab N et al. The longer term outcome of children born to mothers with epilepsy. J Neurol Neurosurg Psychiatry. 2004;75:1575–83.

Vajda FJ et al. Critical relationship between sodium valproate dose and human teratogenicity: results of the Australian register of anti-epileptic drugs in pregnancy. J Clin Neurosci. 2004;11:854–8.

Wide K et al. Major malformations in infants exposed to antiepileptic drugs in utero, with emphasis on carbamazepine and valproic acid: a nation-wide, population-based register study. Acta Paediatr. 2004;93:174–6.

Sabers A et al. Epilepsy and pregnancy: lamotrigine as main drug used. Acta Neurol Scand. 2004;109:9–13.