Epilepsy and cognitive development

Epilepsy drugs and child development

Women who take the antiepileptic drug valproate during pregnancy could impair their child’s cognitive development, according to a new study.

The Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) study followed more than 300 children born between 1999 and 2004 to women with epilepsy in the United States and the United Kingdom. The women took one of four epilepsy drugs: carbamazepine, lamotrigine, phenytoin, or valproate. At age 3, children of mothers who took valproate had an average IQ six to nine points lower than children exposed to the other three drugs.

“Valproate has an important role in treating epilepsy because some patients’ seizures can be controlled only with valproate,” says lead study author Kimford Meador, Emory professor of neurology. “However, we are recommending that women with epilepsy try another drug first.”

The effects of valproate appear to be dose-dependent, Meador notes, so taking lower dosages more frequently could reduce risk. The study was published in the April 16, 2009, issue of the New England Journal of Medicine. Previously, the NEAD study found that valproate also increases the risk of birth defects.

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Emory Medicine - Spring 2009