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A multicenter study published in the prestigious New England Journal of Medicine (Meador et al. NEJM 2009 vol:360 pages 1597 -605) evaluated cognitive function in 309 children at 3 years of age after fetal exposure to antiepileptic drugs.
Children exposed to valproate on average had an IQ score 6-9 points lower than those exposed to lamotrigine, phenytoin or carbamazepine. The article concluded that in utero exposure to valproate is associated a lower IQ at 3 years of age. Valproic acid is therefore not likely to be the best AED to use during pregnancy, unless the benefits in terms of seizure control outweigh the risks.
Robert S. Fisher, M.D., Ph.D.
Editor-in-Chief
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