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Valproate linked with autism risk

Pregnant women taking valproate may increase their child’s risk of developing autism, early data from a study published in Neurology suggest (2008;71:1923).

The ongoing study found that out of 64 children exposed to valproate, four (6.3 per cent) had autism or features of the disorder, making the children whose mothers had taken the drug during pregnancy seven times more likely than the control group to develop autism (incidence: 0.9 per cent). This was also higher than the reported incidence of six per 1,000 children in the general population.

The study, conducted by the Liverpool and Manchester Neurodevelopment Group, recruited 632 children between 2000 and 2006, nearly half of whom were exposed to epilepsy drugs during gestation.

Sixty four children were exposed to valproate, 44 to lamotrigine, 76 to carbamazepine and 65 to other epilepsy drugs. Nine children have been diagnosed with autism and one has shown symptoms of the disorder. Seven of these had mothers who took an epilepsy drug while pregnant.

The study’s author Gus Baker emphasised that more research needs to be done and said: “This is a relatively young cohort with many children falling below the average age of detection and diagnosis of ASD [autistic spectrum disorders].”

He added: “However, women who take valproate while pregnant should be informed of the possible risks of autism and are encouraged to discuss them with their doctor.”

Commenting on the study, a spokeswoman for Sanofi-Aventis, which markets Epilim, said: “Valproate has been used for many years and epilepsy is a complex disorder. The management of it is complex, particularly during pregnancy when seizure control is critical.”

She added that all epilepsy drugs have been associated with some degree of genetic malformation in children but that seizures themselves can also lead to this and can be fatal.

“It is critical women receive pre- conception counselling from pharmacists to find out what the most appropriate treatment is for them,” she told The Journal.

Citation: The Pharmaceutical Journal URI: 10041190

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