January 31, 2013

expert reaction to study examining link between neurodevelopmental disorders and antiepileptic drugs

A small study in the Journal of Neurology Neurosurgery and Psychiatry suggested that mothers taking the antiepileptic drug sodium valproate while pregnant have a higher chance of having children with autism and other neurodevelopmental disorders. A before the headlines analysis accompanied this roundup.

Prof David Taylor, Royal Pharmaceutical Society spokesperson on mental health, said:

“We already know valproate is associated with the highest risk of major and minor congenital malformations compared with other anti-epileptic drugs, and for this reason its use is avoided in pregnancy.  Use of this drug in pregnancy would require a full and frank discussion of the risks with the patient.  Health professionals should ensure that effective contraception is recommended to women of child bearing age who are taking Valproate.”

Dr Gavin Woodhall, Reader in Neuropharmacology at Aston University, said:

“There is now a developing scientific literature based upon the use of valproate as a model of autism in rodents.  Sodium valproate is administered to the pregnant dam during embryonic development and offspring subsequently develop behavioural features (lack of proper social interaction) and neuroanatomical features (loss of specific types of neurons etc) of autism.  Hence, this study in man is consistent with what is seen in animal models and should come as no major surprise. 

“However, this is only a small study as yet, and it is important to take into account the fact that controlling epilepsy in pregnancy is very important, and most women who are treated for epilepsy during pregnancy go on to have perfectly normal babies.”

Reference: 

‘The prevalence of neurodevelopmental disorders in children prenatally exposed to antiepileptic drugs’ by Rebecca Louise Bromley et al., published in The Journal of Neurology Neurosurgery and Psychiatry on Wednesday 30 January 2013.