Seizure Medication Linked to Birth Defects
Problems More Common in Children of Women Taking Depakote
More Evidence on Depakote
Another unpublished study also showed a higher rate of problems in children whose mothers took Depakote during pregnancy. This research will be presented in Vancouver this summer at a meeting of birth defect specialists.
Investigators followed 149 women with epilepsy who took Depakote early during their pregnancy and until after they delivered, Diego Wyszynski, MD, PhD, tells WebMD.
Among mothers taking Depakote, 11% had children with birth defects, the most common of which was spina bifida, in which the development of the spinal cord is incomplete. Similar birth defects were seen in 3% of children of women taking all of the other seizure medications studied, and less than 2% among children of a comparison group of women without epilepsy.
Wyszynski says all the women taking Depakote also took either a multivitamin or folic acid supplements during their pregnancies. It is generally recommended that women who are pregnant or might become pregnant take 400 micrograms of folic acid daily to prevent spina bifida, but Wyszynski says women taking Depakote may need 10 times that amount.
"There is no question in my mind that [Depakote] causes birth defects," Wyszynski tells WebMD. "Women who do not have to take it shouldn't, but those who do may be able to decrease their risk by taking higher doses of folic acid."
American Epilepsy Foundation President Daniel Lowenstein, MD, tells WebMD the good news from the Pennell study is the very low rate of problems seen with the newer seizure medication Lamictal. Sixty women in the study took the drug, and problems were seen in just 2% of their children.
"This is some of the earliest data we have seen on this drug, and it is very encouraging," he says. "We have been suspicious for some time that our full appreciation of the potential adverse effects of various anticonvulsive drugs on fetal development has not been completely understood. Studies like this one are exactly what we need to get as close to the truth as we can."