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Nomination for ABN Honorary Secretary and Honorary Treasurer are now open. Please do consider if you could stand, or could encourage a colleague to stand for these important roles.

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ABN statement on use of sodium valproate in pregnancy

The Association of British Neurologists (ABN) has been concerned for many years about sodium valproate taken in pregnancy. The world-leading UK Epilepsy and Pregnancy Database[i] has, since the mid-1990s, relied upon ABN members to register their patients. Furthermore ABN members were among the first to raise concerns about, and to develop research into, the cognitive effects of valproate on the newborn[ii], [iii]. Neurologists have long recommended that young women should avoid sodium valproate except as a last resort and to use it only when they are fully informed of the potential risks.

 

However, we also recognise that the issue is complicated and that withholding valproate from young women carries its own risks. Sodium valproate is the proven most effective treatment for generalised-onset epilepsy[iv], a common form of epilepsy in children and young people.  Young men with generalised-onset epilepsy therefore can benefit from valproate’s ability to provide freedom from seizures, whereas young women must—for many years now in the UK—first try less effective or less proven treatments for their epilepsy. When a young woman is already taking sodium valproate—for example, if prescribed to her as a child but still needed years later—and is planning a pregnancy, changing medication may open her up to risks.

 

The ABN is working closely with the Medicines and Healthcare products Regulatory Agency (MHRA) to ensure that any young woman who is taking sodium valproate is fully aware of, and is repeatedly reminded of, the risks of becoming pregnant whilst taking this treatment. 



[i] Morrow J, Russell A, Guthrie E, Parsons L, Robertson I, Waddell R, Irwin B,
 McGivern R C, Morrison P J, Craig J. Malformation risks of antiepileptic drugs in pregnancy: a prospective study from the UK Epilepsy and Pregnancy Register. J Neurol Neurosurg Psychiatry 2006;77:193–198.

[ii] Adab N, Kini U, Vinten J, Ayres J, Baker G, Clayton-Smith J, et al. The longer term outcome of children born to mothers with epilepsy. J Neurol Neurosurg Psychiatry 2004; 75: 1575–83.

[iii] Meador KJ, Baker G A, Browning N, Cohen MJ, Bromley RL, Clayton-Smith JLaura LA, Kalayjian A, Kanner A, Liporace JD, Pennell PB, Privitera M, Loring DW, for the NEAD Study Group* Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurology 2013 http://dx.doi.org/10.1016/S1474-4422(12)70323-X

 

[iv]Marson AG, Al-Kharusi AM, Alwaidh M, Appleton R, Baker GA, Chadwick DW, Cramp C, Cockerell OC, Cooper P, Doughty J, Eaton B, Gamble C, Goulding RP, Howell SJL, Hughes A, Jackson M, Jacoby A, Kellett M, Lawson GR, Leach JP, Nicolaides P, Roberts R, Shackley P, Shen J, Smith DF, Smith PEM, Tudur-Smith C, Vanoli A, Williamson PR. The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial. Lancet 2007;369:1016–1026. PMID: 17382828.

 

[v]https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/457961/aagv1.pdf (accessed 13th December 2015)

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News

Nomination for ABN Honorary Secretary and Honorary Treasurer are now open. Please do consider if you could stand, or could encourage a colleague to stand for these important roles.

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Events

Save the date Wednesday 9 - Friday 11 May 2018.

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