Cognitive Function at 3 Years of Age after Fetal Exposure to Antiepileptic Drugs
The New England Journal of Medicine

Special Episode of Hallway Conversations on this Topic!
In a special episode of Epilepsy.com's Hallway Conversations, Dr. Joseph Sirven, Professor of Neurology at Mayo Clinic Arizona and Editor-in-Chief of Epilepsy.com/Professionals, interviews Dr. Kimford Meador from Emory University on this topic.

IQ Harmed by Epilepsy Drug in Utero
New York Times - United States
By RONI CARYN RABIN Pregnant women who took a popular epilepsy drug, also widely used to treat migraines, pain and psychiatric disorders, had children whose ...

Epilepsy Drug Linked to Babies' Lower IQ
WebMD - USA
By Kathleen Doheny April 15, 2009 -- Women with epilepsy who took the drug valproate ( Depakote) during pregnancy gave birth to children whose IQ at age 3 ...

USA Today (USA)
4/16/2009

Valproate is riskiest anti-epileptic drug for pregnant ...

BY Rita Rubin

A study today adds more evidence that women who could get pregnant shouldn't take the commonly prescribed anti-epileptic drug valproate, also used to treat migraines and bipolar disorder.

The study, which is published in The New England Journal of Medicine, assessed 258 2- and 3-year-olds whose mothers took one of four anti-epileptic drugs while pregnant.

On average, children exposed to valproate had an IQ of 92, six to nine points lower than the others. Still, the authors caution, uncontrolled seizures in the mother are riskier than any anti-epileptic drug, so women shouldn't suddenly stop their medication.

About 1% of Americans have epilepsy, a seizure disorder. Most women with epilepsy have normal babies, although compared with the general population, the children have a higher risk of birth defects.

Some anti-epileptic medications have been used for more than a century, but doctors didn't begin to recognize their pregnancy risks until the 1960s, says lead author Kimford Meador, an Emory University neurologist in Atlanta.

And, Meador says, it wasn't until this century that differences among the drugs began to emerge. He says "pretty definitive studies" have shown that valproate increases the risk of structural deformities, such as spina bifida, to about 10% -- more than other anti-epileptic drugs.

One drawback of Meador's study is the lack of a comparison group of children not exposed to anti-epileptic drugs, says Lewis Holmes, a Harvard pediatrician who directs the North American Antiepileptic Drug Pregnancy Registry.

Some research suggests that the average IQ has risen from 100 to 110 or 115, Holmes says. If so, he says, even lamotrigine, which fared best in Meador's study, might have a significant effect.

Since his registry started in 1997, Holmes says, "there's been a steady decline" in women taking valproate. But Meador says the most recent government data show that in 2006, it was the second-most commonly prescribed anti-epileptic medication among U.S. women of childbearing age.

Most anti-epileptic drug users don't have epilepsy. In fact, says Eric Hargis, CEO of the Epilepsy Foundation, "some consumers might not actually realize they're taking an epilepsy drug."

Lyrica was approved in 2004 for epilepsy (too recent for Meador's study), but only 10% of those taking it have epilepsy, Hargis says. Because of TV ads, it may be best-known for treating fibromyalgia, a condition marked by muscle and joint pain and fatigue that affects more women than men.

Copyright © 2009 USA TODAY

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Authored Date: 
04/2009