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Valproate Exposure During Pregnancy Can Impair Child's Cognitive Development ATLANTA -- April 15, 2009 -- Three-year-olds whose mothers took valproate during pregnancy had average IQs 6 to 9 points lower than children exposed to 3 other antiepileptic drugs, according to a study published in the April 16 issue of the New England Journal of Medicine. The study's authors say that women of childbearing age should avoid valproate as a first choice drug for the treatment of epilepsy. "There are clear risks associated with valproate, and physicians have an obligation to inform women about them," says lead author Kimford Meador, MD, Emory University School of Medicine, Atlanta, Georgia. "Valproate still has an important role in treating epilepsy, because some patients' seizures can only be controlled with valproate. However, we are recommending that women with epilepsy try another drug first." The Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study is an ongoing study following more than 300 children born to women with epilepsy between 1999 and 2004. Investigators at 25 epilepsy centres in the US and the UK are participating. At enrollment, the women were taking a single antiepileptic agent: carbamazepine, lamotrigine, phenytoin or valproate. Valproate's effects on child IQ appear to be dose-dependent, so it may be possible to reduce risk by taking it in lower doses more frequently or in a sustained release formulation, said Dr. Meador. A child's IQ is usually strongly influenced by the mother's IQ. Out of the 4 antiepileptic drugs studied, only valproate disrupted this relationship. Preliminary results describing the children's IQs at 2 years of age were reported at the end of 2006. The studies' findings were strengthened by researchers' ability to include more children and measure their progress after 3 years. The researchers plan to follow the children until age 6. SOURCE: Emory University E-mail this page to a friend or colleague! To print, use this version