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Birth Defects Linked to Valproic Acid

6 Birth Defects More Common in Pregnant Women Who Take Epilepsy Drug

6 Birth Defects Linked to Valproic Acid continued...

It all comes down to a woman’s personal risk and benefit profile, she says.

“The risk of untreated illnesses are great to both the woman and fetuses, and sometimes taking this medication may be the best choice,” she says. “You need to look at it on a case-by-case basis, and look at reasonable alternatives. Sometimes there are no other choices because to stay well, you must be on this specific medication at high doses."

“If you are on [valproic acid] and it’s working well, don’t do anything rash like going off your medication,” she says.  “Go to your doctor and figure out if there are safer alternatives for treating your seizure or bipolar disorder during pregnancy."

Ideally this conversation should take place before you become pregnant. “Once you are pregnant, it’s a different can of worms,” she says.

Counseling Women Before Pregnancy

“The study provides further verification of our concerns of valproic acid standing out as high risk for birth defects during pregnancy and [conferring a] higher risk than other medications we can choose to prescribe for treatment of epilepsy, migraine, and bipolar disorder during pregnancy,” says Page B. Pennell, MD, a neurologist and the  director of research in the division of epilepsy at Brigham and Women's Hospital in Boston, and the chairwoman of the professional advisory board for the Epilepsy Foundation.

The study also provides information on the specific birth defects that are increased in the offspring of women with epilepsy who took the drug during their first trimester, she says.

“It is necessary to discuss these risks with women prior to pregnancy,” she tells WebMD. “I tell all my patients to try and switch to a safer medication because these birth defects can have a huge impact on a child’s life.”

“It is prudent and necessary for us to try and find another medication to control epilepsy or bipolar disorder among women of childbearing age,” she says. “There are several medications that we can choose from, and almost any other medication will be a safer option for the developing fetus."

The good news is that more than 90% of women with epilepsy will have normal, healthy infants, according to the Epilepsy Foundation.

Fully half of all pregnancies are unplanned, Pennell says. This conversation needs to take place as soon as a woman hits puberty and continue through all of her childbearing years.

Depakote Manufacturer Responds

Depakote is manufactured by The Abbott Laboratories in Abbott Park, Ill.

“The risk of birth defects associated with valproic acid is well known and clearly stated in Depakote's medication labeling,” says Abbott spokeswoman DeAnna DuBose.

“Because both the seizures themselves and the medications used to treat those seizures pose risks, it is crucial that women who are pregnant or may become pregnant work extensively with their physicians to balance the importance of seizure control with any potential effects of epilepsy therapy,” she says.

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