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Valproate medicines and risks in pregnancy

Research has shown that taking valproate medicine during pregnancy can harm your unborn child. Valproate medicines include sodium valproate (Epilim, Depakote) and valproic acid (Convulex). Taking valproate medicine during pregnancy can cause birth defects and problems with a child’s development and learning.

Doctors in the UK have been advised not to prescribe valproate to girls, women who could get pregnant, or women who are pregnant. If you fit into one of these groups, your doctor should only prescribe valproate to you if other epilepsy medicines do not suit you.

What sort of problems can valproate cause?

Valproate can cause two sorts of problems when taken during pregnancy: birth defects and problems with learning and development.

Birth defects

In women who take valproate during pregnancy, around 1 in every 10 babies will be born with birth defects.

Birth defects happen when the baby doesn’t develop properly in the womb. Other names for birth defects include congenital anomalies, congenital malformations and congenital abnormalities.

Birth defects seen in children whose mothers took valproate during pregnancy include:

  • Spina bifida (where the bones of the spine do not develop properly)
  • Facial and skull malformations (including cleft lip and palate, where the upper lip or facial bones are split)
  • Malformations of the limbs, heart, kidney, urinary tract and sexual organs

Learning and development problems

In women who take valproate during pregnancy, between 3 and 4 in every 10 children may have problems with learning and development. The long-term effects aren’t known.

Problems with learning and development include:

  • Walking and talking later than other children of the same age
  • Poor speech and language skills
  • Memory problems
  • Lower intelligence than other children of the same age

Children whose mothers took valproate while pregnant are more likely to have autism or an autism spectrum disorder. There’s also some evidence that children may be more likely to develop symptoms of attention deficit hyperactivity disorder (ADHD).

I’m taking valproate and want to get pregnant. What should I do?

If you’re taking valproate and want to get pregnant, speak to your family doctor. They can arrange for you to see an epilepsy specialist for advice about planning your pregnancy. Don’t stop taking your medicine, unless the specialist advises you to do so. If you suddenly stop taking your epilepsy medicine, your seizures could increase, or become more severe.

I’m already pregnant. Should I stop taking valproate?

You should only stop taking valproate if your doctor advises you to. Stopping any epilepsy medicine suddenly could cause you to have more seizures, or more severe seizures. This could be harmful to you and your baby.

If you haven’t had advice about taking your medicine during pregnancy, it’s important to talk to your doctor as soon as possible. They should arrange for you to see a specialist to get the advice you need.

It’s important to know that for some women, valproate is the only medicine that will control their seizures. If this is the case for you, your specialist might advise you to keep taking it, even during pregnancy. This is because the benefit of controlling your seizures could outweigh the risk of valproate harming your baby. 

Can other epilepsy medicines harm my baby if taken during pregnancy?

Some other epilepsy medicines can put your baby at risk of birth defects if taken during pregnancy. But research shows the risk is lower than with valproate medicines. See our page about epilepsy medicines and pregnancy for more information.

Where can I find out more?

The Medicines and Healthcare products Regulatory Agency (MHRA) has produced a toolkit to make sure women are better informed about the risks of taking valproate medicines during pregnancy. It has also published a patient guide for women taking valproate medicines.

If you would like to see this information with references, visit the Advice and Information references section of our website. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 0808 800 5050.

Code: 
F155.01
Event Date: 
Thursday 12 October 2017 - 12:59

Epilepsy Action would like to thank Beth Irwin, epilepsy nurse/midwife, The Royal Hospital, Belfast, for her contribution to this information.

Beth Irwin has no conflict of interest to declare.

This information has been produced under the terms of The Information Standard.

  • Updated October 2017
    To be reviewed October 2020

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