Depakote Decision Difficult for Pregnant Moms

Houston, TXWhen weighing the benefits of taking a medication against the potential negatives, people usually consider the severity of the condition being treated. More serious conditions might make a person willing to take a drug with more serious risks. For pregnant women taking Depakote and worried about Depakote side effects, the risks of having untreated seizures could be just as serious as the risks associated with taking Depakote during pregnancy.

Researchers in Australia recently conducted a study into the risks of having untreated epilepsy while pregnant, according to Epilepsy Research UK (epilepsyresearch.org.uk). To conduct the study, researchers analyzed data on 148 women who had epilepsy to examine links between fetal malformation and seizure control. The women included in the study were not taking antiepileptic medications before or during their first trimester.

What researchers found was that pregnant women who did not take medication for their epilepsy - regardless of whether they had not taken an antiepilepsy medication for a long time prior to pregnancy or in preparation for pregnancy - were less likely to maintain seizure control. Women who stopped taking their antiepileptic medication in preparation for pregnancy, however, were more likely to begin taking their medication again by the time they gave birth.

The study was published in Seizure (published online 8/29/14; abstract available here) and found that the rates of fetal malformation were similar in untreated and treated pregnancies when fetuses exposed to valproate (a generic name for Depakote) and topiramate were not included in consideration. Researchers referred to valproate as a “known AED teratogen.”

“Leaving epilepsy untreated during pregnancy appears disadvantageous from the standpoint of seizure control: it also does not reduce the hazard of fetal malformation unless it avoids valproate or topiramate intake during pregnancy,” the study’s authors wrote.

Treatment of seizures is an important consideration for pregnant women. But some women were prescribed valproate products to treat migraine headaches. The FDA has said valproate products “should not be taken by pregnant women for the prevention of migraine headaches,” and changed valproate’s pregnancy category regarding migraines to X, meaning the risk in pregnant women clearly outweighs any possible benefits.

Regarding treatment of seizures and bipolar disorder, the FDA recommends that valproate only be used if other medications are not effective or otherwise not acceptable.