A related editorial discusses the finding of the study, highlighting that valproate use during pregnancy should be avoided if possible. Separately, they note that “one could argue that comparisons to an antiepileptic drug-unexposed group is not clinically useful, because most women with epilepsy and major psychiatric disorders need to continue taking medication owing to the adverse fetal effects of uncontrolled maternal disease. However, this study verifies that the consequences of valproate prenatal exposure are worse than exposure to lamotrigine, which is effective for bipolar disorder as well as epilepsy”.
The MHRA has also previously issued patient and clinician alerts advising that clinicians should not prescribe valproate medicines for epilepsy or bipolar disorder in women and girls unless other treatments are ineffective or not tolerated.