Use of com­mon epilepsy drug in preg­nancy linked to ADHD in kids

The Borneo Post - Nature and health - - Front Page -

When a woman with epilepsy uses the anti-seizure drug val­proate dur­ing a preg­nancy, the odds that her baby will go on to de­velop ADHD rise, a new study sug­gests. The Dan­ish re­port can’t prove that val­proate causes at­ten­tion-deficit/hyper­ac­tiv­ity dis­or­der (ADHD) in these cases, only that there’s an as­so­ci­a­tion. But in the new study, fe­tal ex­po­sure to val­proate was tied to 48 per cent higher odds of a child de­vel­op­ing ADHD, ac­cord­ing to a team led by Dr Jakob Chris­tensen at Aarhus Uni­ver­sity.

The study in­cluded more than 900,000 ba­bies born in Den­mark be­tween 1997 and 2011. The chil­dren’s men­tal health was tracked from birth un­til they av­er­aged about 10 years of age. Chris­tensen’s group con­cluded that “ma­ter­nal use of val­proate dur­ing preg­nancy was as­so­ci­ated with a small but sig­nif­i­cantly in­creased risk of ADHD in the off­spring, even after ad­just­ing for ma­ter­nal psy­chi­atric dis­ease, ma­ter­nal epilepsy,” and other fac­tors.

Other epilepsy drugs ap­peared to have no ef­fect on ADHD rates, the re­searchers noted. The find­ings were pub­lished on­line in JAMA

Net­work Open. Two US ex­perts said that most women with epilepsy are al­ready coun­selled to avoid val­proate dur­ing preg­nancy. “This study pro­vides yet more data high­light­ing risks of us­ing val­proate in women of child­bear­ing age,” said Dr. Fred Lado, who di­rects epilepsy care for Queens and Long Is­land as part of the New York City North­well Health sys­tem.

Ac­cord­ing to Lado, it’s been long known that “val­proate pro­duces birth de­fects in up to 10 per­cent of chil­dren ex­posed in utero.” The drug also “re­duces av­er­age IQ (in ex­posed off­spring) and in­creases the like­li­hood of be­havioural prob­lems,” he said.

The new study “adds to the al­ready com­pelling list of rea­sons for avoid­ing val­proate use in women of child­bear­ing age,” Lado said. In most cases, women can switch to an­other an­ti­seizure medicine, but “in the rare cases where there is no al­ter­na­tive to val­proate, women should be in­formed fully about the risks and coun­selled on the use of con­tra­cep­tives,” he added.

Dr An­drew Ades­man is chief of child de­vel­op­men­tal and be­havioural pae­di­atrics at the Chil­dren’s Med­i­cal Cen­tre of New York in New Hyde Park. He said the new study “once again raises the con­cern that pre­na­tal ex­po­sure to val­proate puts a fe­tus at in­creased risk of ADHD as a child.” Ades­man stressed that while avoid­ance of val­proate is the pre­ferred op­tion dur­ing a preg­nancy, women who have taken the drug while preg­nant should not panic.

“It must be kept in mind that, de­spite the in­creased risk of ADHD, only about 10 per cent of chil­dren ex­posed to val­proate pre­na­tally ended up hav­ing ADHD,” Ades­man said. “So, women who were treated with val­proate dur­ing their preg­nancy should be re­as­sured by the fact that the chances are pretty small that their child will have ADHD as a func­tion of val­proate ex­po­sure dur­ing preg­nancy.”

*All ma­te­ri­als are only for your in­for­ma­tion, and should not be con­strued as med­i­cal ad­vice. Where nec­es­sary, ap­pro­pri­ate pro­fes­sion­als should be con­sulted

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