Epilepsy Drug Birth Defects Lead to New Guidelines for Pregnant Women

According to new guidelines issued by the American Academy of Neurology and American Epilepsy Society, pregnant women should avoid taking the drug valproate, which could include Depakote, Depacon and several generic versions. The risk of valproate birth defects appears to outweigh the benefits provided by taking the drug during pregnancy, which is usually a safe time for most women with epilepsy.

Studies have established that valproate side effects could increase the risk of birth defects like cleft palate and spinal bifida. Use of the drug has also been linked to lower IQs in children when compared to babies exposed to other epilepsy drugs during pregnancy.

The new guidelines were presented Monday by a panel of experts at the annual meeting for the American Academy of Neurology in Seattle and published online in the journal Neurology.

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Approximately 500,000 women in the U.S. who are of childbearing age have epilepsy and about 3 to 5 out of every 1,000 births are to women with epilepsy.

The panelists suggested that pregnancy is relatively safe for women with epilepsy, but they recommended that women avoid taking valproate due to the risk of birth defects, and indicate that they may also want to avoid taking phenytoin (Dilantin) and phenobarbital, which have also been associated with children having lower IQs.

The guidelines also recommend that women should avoid taking more than one anti-epileptic drug at the same time, have their blood tested regularly to adjust any medications for the risk of seizures, take at least 400 micrograms of folic acid every day and avoid smoking during the pregnancy.

Valproate is sold under the brand name Depacon and as a generic by several different manufacturers. The popular antiepiletic drug Depakote (divalproex sodium) is a tablet that becomes valproate once it is in the body and has been associated with the same risks.

In October 2006, the warning label was updated for possible Depakote birth defects associated with taking the drug during pregnancy. The warning was added after a study published in the August 2006 issue of Neurology found that approximately 20.3% of babies born after the mother took Depakote suffered serious adverse outcomes, compared with other drugs that had lower rates between 1% and 10.7%.

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3 Comments

  • LeslieNovember 19, 2012 at 12:45 am

    I took Dilantin during my first pregnancy. My child has even been diagnosed with what doctors refer to as fetal hydentoid syndrome. Her bridge on her nose is flat, her fingers are wider spaced, her nipples are wider spaced, and she has a heart malformation. She was a very low tone child especially in the upper body and had to have extra help to learn many everyday childhood activities. Also to go[Show More]I took Dilantin during my first pregnancy. My child has even been diagnosed with what doctors refer to as fetal hydentoid syndrome. Her bridge on her nose is flat, her fingers are wider spaced, her nipples are wider spaced, and she has a heart malformation. She was a very low tone child especially in the upper body and had to have extra help to learn many everyday childhood activities. Also to go along with these issues upon entering school, she was diagnosed with ADHD and ODD. I have always wondered if my daughter was entitled to some type of compensation for all of the poking and prodding she has undergone since birth, due to me being told I needed to stay on that horrible medicine- which upon switching doctors I was told NO Female should ever be placed on. I just hope my daughter's testosterone levels are not elevated like mine due to dilantin consumption and she don't start to get facial hair as she hits puberty! I'm not one to take a hand out or ask for assistance, my husband and I work everyday, I know there are risks with every medicine you take, but when you are pregnant you are not only dealing with your life you are dealing with the life and future of an unborn child.

  • AmieMarch 25, 2011 at 9:43 pm

    I was on the drug Dilantin while pegnant, at 4 months had a stroke from a blood vessel bursting. I have many questions and wondering if the Dilantin had anything to do with my stroke.

  • TracyFebruary 24, 2010 at 4:35 am

    I just read about the birth defects with the epilepsy drugs while pregnant and I have been wondering about this for quite a while. My youngest son was born in November of 2001 and I was either taking Dilantin or Depaokote at the time. He has always had a learning problem, could that be the reason?

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