Pregnancy, Childbirth, and Parenting

Epilepsy Drug Taken During Pregnancy May Impair Baby’s Intelligence

Children of women who used a common epilepsy drug known as Valproate during pregnancy were shown to suffer from an impaired Intelligence Quotient (IQ) compared to children of women who took other epilepsy drugs. Lower IQs were observed among these children up until the age of three years.

Valproate is marketed under the name of Epilim by Sanofi-Aventis and also sold as Depakine by Abbott Laboratories. The drug is commonly prescribed for epilepsy, migraines and bipolar disorder as well as other conditions. The findings of the new research add to mounting evidence that the drug is harmful to unborn children. In a prior study of the effects of valproate, results revealed that pregnant women who take the epilepsy drug might significantly increase the risk of their child developing autism. Another recent study indicated an association of yet another epilepsy drug, topiramate, with birth defects such as cleft palates and genital defects. Additional studies have shown that other drugs used to treat epilepsy have been also been linked to an increased risk of birth defects including spina bifida and heart malformations.

According to Kimford Meador of Emory University in Atlanta and colleagues, “This finding supports a recommendation that valproate not be used as a first-choice drug in women of childbearing potential.” The report was published in the New England Journal of Medicine.

Regarding the continued widespread use of valproate and in consideration of how commonly physicians prescribe it, Meador noted, “You have to wonder why so much of it is being written for women with epilepsy after all this time or, for that matter, for anything. I suspect it's even worse for headache or bipolar, because that's where most of the scripts are for this drug.” In addition, when a woman is taking valproate and becomes pregnant, abruptly halting the drug can be dangerous because this can lead to an increased occurrence of seizures and endanger the fetus. As valproate is the most effective treatment in only about 5 percent of cases, Meador said, “I think the simple message is, try something else first.” He then added, that the lower the dose of the drug, the lower the risk that it will affect IQ, and although there may not be a safe dose, “if it's the only drug that works, and it works in a low dose, then it may be OK.” Meador added.

During the study of 303 pregnant women who were each using an anti-epileptic drug, IQ scores of the children born to them were assessed at age three. Children of mothers who had taken valproate during pregnancy were found to have an IQ of six to nine points lower than children of mothers who had used any of three other drugs for treatment of epilepsy. Women taking GlaxoSmithKline Plc.'s Lamictal, Novartis AG.'s Tegretol and Pfizer Inc.'s Dilantin, all had children having about the same level of intelligence. The researchers will continue to follow the study participants for an additional three years.

Approximately 25,000 children are born to mothers with epilepsy each year within the U.S. and many of these mothers may actively be taking valproate. Eric Hargis, president of the Epilepsy Foundation in Washington, says that those women who become aware of the dangers of the drug should not abruptly stop using it. He urged, “It’s important to stress to readers that if they become frightened, they should not simply stop taking the drug, because that can be even more dangerous.” Instead women should speak with their healthcare providers regarding their concerns.