Back to Journals » Therapeutics and Clinical Risk Management » Volume 1 » Issue 1

Should valproate be taken during pregnancy?

Authors Mervyn J Eadie, Frank JE Vajda

Published 15 April 2005 Volume 2005:1(1) Pages 21—26

Mervyn J Eadie1, Frank JE Vajda2

1Department of Medicine, University of Queensland, Royal Brisbane Hospital, Brisbane, QLD, Australia; 2Australian Centre for Clinical Neuropharmacology, Raoul Wallenberg Centre, Neurosciences and University of Melbourne at St Vincent’s Hospital, Melbourne, VIC, Australia

Abstract: The Australian Registry of Antiepileptic Drug Use in Pregnancy includes 172 instances in which women took sodium valproate, with or without other antiepileptic drugs, during pregnancy. These pregnancies resulted in a substantially higher (p < 0.05) rate of malformed offspring (15.1%) compared with 348 pregnant women who took antiepileptic drugs other than valproate (2.3%) and 40 pregnancies in epileptic women who took no antiepileptic drugs (2.5%). At valproate doses of 1400 mg and below per day, the mean rate of pregnancies with fetal malformations was 6.42% and did not seem to be dose-dependent. At higher valproate doses, the mean rate of pregnancy with fetal malformation was 33.9% and appeared to increase with increasing drug dosage. This finding suggests the need for reappraisal of the use of valproate in women who may become pregnant or are pregnant whilst the drug is taken. The therapeutic policy adopted may depend on whether valproate doses below 1400 mg per day are regarded as safe for the fetus. This study indicates that the risk of malformation associated with such doses was just statistically significantly (p < 0.05) higher than that associated with other antiepileptic drugs. Various possible clinical scenarios are discussed.
Keywords: epilepsy, malformations, pregnancy, valproate

Download Article [PDF] 

Readers of this article also read:

Adverse pregnancy outcomes after exposure to methylphenidate or atomoxetine during pregnancy

Bro SP, Kjaersgaard MIS, Parner ET, Sørensen MJ, Olsen J, Bech BH, Pedersen LH, Christensen J, Vestergaard M

Clinical Epidemiology 2015, 7:139-147

Published Date: 29 January 2015

Clinical outcomes and management of mechanism-based inhibition of cytochrome P450 3A4

Shufeng Zhou, Eli Chan, Xiaotian Li, Min Huang

Therapeutics and Clinical Risk Management 2005, 1:3-13

Published Date: 15 April 2005

Depression and drug utilization in an elderly population

Raffaele Antonelli Incalz, Andrea Corsonello, Claudio Pedone, Francesco Corica, Pierugo Carbonin

Therapeutics and Clinical Risk Management 2005, 1:55-60

Published Date: 15 April 2005

Drug-related problems in hospitalized patients on polypharmacy: the influence of age and gender

Yvonne Koh, Fatimah Bte Moideen Kutty, Shu Chuen Li

Therapeutics and Clinical Risk Management 2005, 1:39-48

Published Date: 15 April 2005

Elective open abdominal aortic aneurysm repair: a seven-year experience

Stuart MacKenzie, judith R Swan, Cate D’Este,  Allan D Spigelman

Therapeutics and Clinical Risk Management 2005, 1:27-31

Published Date: 15 April 2005