Epilepsy Drug, Pregnancy Raise Autism Risk
Study Shows Kids at Risk for Autism When Pregnant Women Take Valproate
Effects on Brain Development
Page Pennell, MD, director of the epilepsy program at Emory University in Atlanta, says the study is "very helpful" because it "is confirmatory of other smaller studies that we need to be concerned about, not only the effects of the medications during the first trimester, but also about continued effects of the medication on the developing brain."
Previous studies suggested concern about the effects of valproate in particular, Pennell tells WebMD, and that "the effects may be more selective for verbal abilities. The strength of this study that stands out is, there was really a rather large cohort of patients followed prior to birth and then in a systematic way up to the age of 6 years old."
Sodium valproate is an effective drug used to control seizures, Bromley says. She adds that some women have been prescribed the medication because "it is very effective at controlling the type of epilepsy they have."
Pennell says the study suggests the need to "consider exposure throughout the entire pregnancy" and even before conception. "Also, this study raises concern not only for the effects on brain development in general, but the specific finding of autism spectrum disorders points out that the children should be followed closely to be able to identify features of autism during development to allow early intervention."
She says she'd recommend that women of childbearing age steer clear of valproate unless it's the only medication that can control seizures. "Most of these women unfortunately have to be on a medicine. But the idea is, women of childbearing age should be on another anti-epileptic drug."
Pennell says 50% percent of pregnancies in the U.S. are unplanned, so women of childbearing age should talk carefully with their doctors about any anti-epileptic medications.
Laureen Cassidy, a vice president for Abbott Laboratories, which manufactures Depakote, a brand-name version of valproate, says "uncontrolled seizures can cause permanent damage" to the brains of children and "for pregnant women can be fatal to both mother and child." The product's label "makes it clear that it should not be used as a first-line treatment for women of childbearing age."
Raquel Powers, another spokeswoman, says "it's a global drug" and that its risks are well known.