Sodium valproate should not be routinely prescribed for women, say medics

Epilepsy Society: Senior medics have warned that the epilepsy drug sodium valproate should not be prescribed to women with epilepsy who are of child bearing age, unless there has been a full discussion of the potential risks and benefits to the woman and any future unborn child. The Academy of Medical Royal Colleges has named the controversial drug as one of 40 common treatments for a range of ailments, that should not be routinely prescribed.

The AMRC represents 21 medical royal colleges in the UK. It says sodium valproate, also known as Epilim, Episenta and Epival, should not be prescribed for women of child bearing age with epilepsy, migraine or bipolar disorder, unless other medications are not working.

Epilepsy Society says

Ley Sander, medical director at Epilepsy Society and professor neurology at UCL Institute of Neurology, said advice from the AMRC was in keeping with the latest guidelines for sodium valproate, issued by the Medical and Healthcare products Regulatory Agency.
Research shows that sodium valproate can cause serious problems in a developing baby. Of babies born to women who take the drug during pregnancy, one in ten (10 per cent) is at risk of a birth defect and up to four in ten (40 per cent) are at risk of developmental and learning problems as they grow.
Professor Sander said: ' For some women sodium valproate may be the only drug that will control their seizures and this is one of the biggest challenges for both doctors and patients. Seizures are not benign events. In some circumstances tonic clonic seizures can cause miscarriage, traumas related to falls or blood conditions that may harm the developing baby.
'It is very important to discuss the risks of sodium valproate against the risks of seizures for both mother and the developing child. Sodium valproate should only be prescribed if no other epilepsy drug will work.
'Under no circumstances should a woman stop taking her drugs without consulting her GP or neurologist. This is why preconception counselling is so important.'

Choosing wisely campaign

A new campaign by the AMRC, Choosing Wisely, urges all patients to ask doctors five questions when seeking treatment:

• Do I really need this test, treatment or procedure?
• What are the risks or downsides?
• What are the possible side effects?
• Are there simpler, safer options?
• What will happen if I do nothing?