A fetus exposed to Valproic Acid (Depacon) has a five-fold elevated risk of developing autism and three-fold elevated risk for developing autism spectrum disorder
Valproic acid (VPA), is an acidic chemical compound that is used as an anticonvulsant and mood-stabilizing drug, primarily in the treatment of epilepsy, bipolar disorder, and, less commonly, major depression, migraine headaches and schizophrenia. VPA is marketed under the various brand names: Depakote, Depakote ER, Depakene, Depakene Crono, Depacon, Depakine, Valparin and Stavzor.
In the United States VPA is used as a mood stabilizer and an anticonvulsant – it is under investigation for treatment of HIV and various cancers.
Women who take VPA during pregnancy may increase the risk of childhood autism and autism spectrum disorder.
Jakob Christensen, PhD, of Denmark’s Aarhus University Hospital, and colleagues found – the absolute risks were 2.5% and 4.4% respectively, and remained significantly elevated after adjustment for parents’ epilepsy and psychiatric disease. “For women of childbearing potential who use anti-epileptic medications, these findings must be balanced against the treatment benefits for women who require VPA for epilepsy control.” However, “because autism spectrum disorders are serious conditions with lifelong implications for affected children and their families, even a moderate increase in risk may have major health importance.”
Kimford Meador, MD, and David Loring, PhD, both of Emory University in Atlanta, would like women to be counseled regarding the risk factors of autism and autism spectrum disorder, when taking VPA during pregnancy. ”Approximately half of pregnancies in the U.S. are unplanned, delaying discussions of treatment risks until a pregnancy is considered will leave a substantial number of children at unnecessary risk. Women of childbearing potential should be informed of the potential risks of fetal valproate exposure before valproate is prescribed.”
In a study of, 655,615 children born in Denmark, 5,437 children developed either childhood autism, Asperger syndrome, atypical autism, or other unspecified pervasive development disorders. Of the 5,437 children, 508 were exposed to valproate during pregnancy. Children of mothers with epilepsy (432 of 508), were 2.9 times more likely to develop autism when exposed to valproate. The risk for kids exposed to valproate during gestation was also elevated even if the mother was not taking it for epilepsy.
“We cannot exclude the possibility that children of women who use valproate during pregnancy may be examined more carefully for autism spectrum disorders, because valproate has been associated with adverse effects.” said Christensen.
The study did, however, lack data on the dose of valproate, and whether women took the valproate they picked up from the pharmacy. The study also lacked their alcohol and folic acid supplement use during pregnancy.