Valproate: life-saving, life-changing
Antiepileptic medications, and valproate principally, are commonly prescribed teratogens. There is significant concern that we are not doing enough to educate clinicians and potential parents about the risks of valproate in pregnancy. There is clear advice from the Medicines and Healthcare products...
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| Veröffentlicht in: | Clinical medicine (London, England) England), 2018-04, Vol.18 (2), p.s1-s8 |
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| description | Antiepileptic medications, and valproate principally, are commonly prescribed teratogens. There is significant concern that we are not doing enough to educate clinicians and potential parents about the risks of valproate in pregnancy. There is clear advice from the Medicines and Healthcare products Regulatory Agency and the International League Against Epilepsy about the risks of valproate exposure in utero. Reviews and guidelines that are focused on fetal risk, however, fall short in being able to fully replicate the complexity of a real clinical decision. Valproate is certainly life-changing if your child is one of the 10% with a major malformation or 30–40% with a neurodevelopmental disorder, but valproate is also potentially life-saving in the context of ensuring the best possible seizure control for some mothers with epilepsy. There are significant knowledge gaps regarding the risks to mothers who elect to take another drug, or to mother and baby if she comes off medication entirely. We also should be doing more to reduce rates of sudden unexpected death in epilepsy (SUDEP), which is recognised as a key target when evaluating all maternal deaths. |
| doi_str_mv | 10.7861/clinmedicine.18-2-s1 |
| format | Article |
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There is significant concern that we are not doing enough to educate clinicians and potential parents about the risks of valproate in pregnancy. There is clear advice from the Medicines and Healthcare products Regulatory Agency and the International League Against Epilepsy about the risks of valproate exposure in utero. Reviews and guidelines that are focused on fetal risk, however, fall short in being able to fully replicate the complexity of a real clinical decision. Valproate is certainly life-changing if your child is one of the 10% with a major malformation or 30–40% with a neurodevelopmental disorder, but valproate is also potentially life-saving in the context of ensuring the best possible seizure control for some mothers with epilepsy. There are significant knowledge gaps regarding the risks to mothers who elect to take another drug, or to mother and baby if she comes off medication entirely. We also should be doing more to reduce rates of sudden unexpected death in epilepsy (SUDEP), which is recognised as a key target when evaluating all maternal deaths.</description><identifier>ISSN: 1470-2118</identifier><identifier>EISSN: 1473-4893</identifier><identifier>DOI: 10.7861/clinmedicine.18-2-s1</identifier><identifier>PMID: 29700085</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Anticonvulsants - adverse effects ; Anticonvulsants - therapeutic use ; Autism ; Babies ; Children & youth ; Congenital diseases ; Convulsions & seizures ; Drug dosages ; England - epidemiology ; Epilepsy ; Epilepsy - drug therapy ; Female ; Humans ; Maternal Exposure - adverse effects ; Mothers ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy - drug effects ; Pregnancy Complications - drug therapy ; Pregnancy Outcome ; Prescriptions - statistics & numerical data ; Teratogens ; Treatment Outcome ; valproate ; Valproic Acid - adverse effects ; Valproic Acid - therapeutic use</subject><ispartof>Clinical medicine (London, England), 2018-04, Vol.18 (2), p.s1-s8</ispartof><rights>2018 © 2018 THE AUTHORS. 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There is significant concern that we are not doing enough to educate clinicians and potential parents about the risks of valproate in pregnancy. There is clear advice from the Medicines and Healthcare products Regulatory Agency and the International League Against Epilepsy about the risks of valproate exposure in utero. Reviews and guidelines that are focused on fetal risk, however, fall short in being able to fully replicate the complexity of a real clinical decision. Valproate is certainly life-changing if your child is one of the 10% with a major malformation or 30–40% with a neurodevelopmental disorder, but valproate is also potentially life-saving in the context of ensuring the best possible seizure control for some mothers with epilepsy. There are significant knowledge gaps regarding the risks to mothers who elect to take another drug, or to mother and baby if she comes off medication entirely. We also should be doing more to reduce rates of sudden unexpected death in epilepsy (SUDEP), which is recognised as a key target when evaluating all maternal deaths.</description><subject>Anticonvulsants - adverse effects</subject><subject>Anticonvulsants - therapeutic use</subject><subject>Autism</subject><subject>Babies</subject><subject>Children & youth</subject><subject>Congenital diseases</subject><subject>Convulsions & seizures</subject><subject>Drug dosages</subject><subject>England - epidemiology</subject><subject>Epilepsy</subject><subject>Epilepsy - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Maternal Exposure - adverse effects</subject><subject>Mothers</subject><subject>Practice Guidelines as Topic</subject><subject>Pregnancy</subject><subject>Pregnancy - drug effects</subject><subject>Pregnancy Complications - drug therapy</subject><subject>Pregnancy Outcome</subject><subject>Prescriptions - statistics & numerical data</subject><subject>Teratogens</subject><subject>Treatment Outcome</subject><subject>valproate</subject><subject>Valproic Acid - 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adverse effects</topic><topic>Anticonvulsants - therapeutic use</topic><topic>Autism</topic><topic>Babies</topic><topic>Children & youth</topic><topic>Congenital diseases</topic><topic>Convulsions & seizures</topic><topic>Drug dosages</topic><topic>England - epidemiology</topic><topic>Epilepsy</topic><topic>Epilepsy - drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Maternal Exposure - adverse effects</topic><topic>Mothers</topic><topic>Practice Guidelines as Topic</topic><topic>Pregnancy</topic><topic>Pregnancy - drug effects</topic><topic>Pregnancy Complications - drug therapy</topic><topic>Pregnancy Outcome</topic><topic>Prescriptions - statistics & numerical data</topic><topic>Teratogens</topic><topic>Treatment Outcome</topic><topic>valproate</topic><topic>Valproic Acid - adverse effects</topic><topic>Valproic Acid - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thomas, Rhys H</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>UK & Ireland Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Clinical medicine (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thomas, Rhys H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Valproate: life-saving, life-changing</atitle><jtitle>Clinical medicine (London, England)</jtitle><addtitle>Clin Med (Lond)</addtitle><date>2018-04</date><risdate>2018</risdate><volume>18</volume><issue>2</issue><spage>s1</spage><epage>s8</epage><pages>s1-s8</pages><issn>1470-2118</issn><eissn>1473-4893</eissn><abstract>Antiepileptic medications, and valproate principally, are commonly prescribed teratogens. There is significant concern that we are not doing enough to educate clinicians and potential parents about the risks of valproate in pregnancy. There is clear advice from the Medicines and Healthcare products Regulatory Agency and the International League Against Epilepsy about the risks of valproate exposure in utero. Reviews and guidelines that are focused on fetal risk, however, fall short in being able to fully replicate the complexity of a real clinical decision. Valproate is certainly life-changing if your child is one of the 10% with a major malformation or 30–40% with a neurodevelopmental disorder, but valproate is also potentially life-saving in the context of ensuring the best possible seizure control for some mothers with epilepsy. There are significant knowledge gaps regarding the risks to mothers who elect to take another drug, or to mother and baby if she comes off medication entirely. We also should be doing more to reduce rates of sudden unexpected death in epilepsy (SUDEP), which is recognised as a key target when evaluating all maternal deaths.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>29700085</pmid><doi>10.7861/clinmedicine.18-2-s1</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Anticonvulsants - adverse effects Anticonvulsants - therapeutic use Autism Babies Children & youth Congenital diseases Convulsions & seizures Drug dosages England - epidemiology Epilepsy Epilepsy - drug therapy Female Humans Maternal Exposure - adverse effects Mothers Practice Guidelines as Topic Pregnancy Pregnancy - drug effects Pregnancy Complications - drug therapy Pregnancy Outcome Prescriptions - statistics & numerical data Teratogens Treatment Outcome valproate Valproic Acid - adverse effects Valproic Acid - therapeutic use |
| title | Valproate: life-saving, life-changing |
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