ADHD: Prenatal AED Valporate +48% risk of ADHD in offspring

New study shows strong evidence for link between prenatal use of Valporate and offspring being born with ADHD. Evidence shows an increased risk of 48% when Valporate have been administered during pregnancy.





Valproate

Valproate is an antiepileptic drug (AED) used in the treatment of epilepsy and many other neurological and psychiatric disorders. Its use in pregnancy is associated with increased risks of congenital malformations and adverse neurodevelopment in the offspring and may be associated with an increased risk of attention-deficit/hyperactivity disorder (ADHD).

Antiepileptic drug (AED) exposure during pregnancy is associated with an increased risk for congenital malformations and delayed cognitive development in the offspring.

In this large population-based prospective cohort study, we evaluated the association between maternal use of valproate and other AEDs during pregnancy and the risk of ADHDintheoffspring, taking maternal history of epilepsy and psychiatric conditions into account (Christensen et al., 2019).

Maternal use of valproate, but not other AEDs, during pregnancy was associated with an 48% increased risk of ADHD in the offspring. These findings have important implications for the counseling of women of childbearing potential using valproate (Christensen et al., 2019).


Epilepsy

Epilepsy is the tendency to have recurrent seizures unprovoked by systemic or acute neurologic insults

Broomfield et al., 2006

Antiepileptic drugs (AEDs) are those which decrease the frequency and/or severity of seizures in people with epilepsy (Broomfield et al., 2006).

The older term, anticonvulsant drug, is still sometimes used as a synonym for AED, but is less accurate because many seizures do not involve convulsive movements (Broomfield et al., 2006).

There is no convincing evidence that AEDs “cure” or alter the natural history of epilepsy (Broomfield et al., 2006).

However, many patients whose seizures have been completely controlled for two or more years can be successfully withdrawn from AEDs (Broomfield et al., 2006).

The therapeutic goal is maximizing seizure control while minimizing adverse drug effects, thus improving the patient’s quality of life (Broomfield et al., 2006).


References

Association of Prenatal Exposure to Valproate and Other Antiepileptic Drugs With Risk for Attention-Deficit/Hyperactivity Disorder in Offspring. 

Christensen J, Pedersen LH, Sun Y, Dreier JW, Brikell I, Dalsgaard S., JAMA Netw Open. 2019 Jan 4;2(1):e186606. doi: 10.1001/jamanetworkopen.2018.6606 PMID: 3064619


Neuropharmacology of Antiepileptic Drugs

Bromfield EB, Cavazos JE, Sirven JI, editors. An Introduction to Epilepsy [Internet]. West Hartford (CT): American Epilepsy Society; 2006. Chapter 3, Neuropharmacology of Antiepileptic Drugs.

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