A drug against epilepsy, the valproate, is under the spotlight of the health authorities due to its possible risks. The Spanish Agency for Medicines and Health Products (AEMPS) has warned of the preliminary results of a study that suggest an increased risk of neurodevelopmental disorders in children whose male parents were treated with the drug in the three months prior to conception.
The agency dependent on the Ministry of Health recommends assessing the need to implement contraceptive measures in these patients, at least until the aforementioned preliminary results are thoroughly analysed. In any case, they do not recommend that any patient abandon the treatment without consulting their doctor, since the symptoms of the disorder could reappear.
“Valproic acid or sodium valproate is a treatment that acts on the central nervous system, avoiding its excitability. It was approved in the 70s of the last century for the treatment of epileptic seizures, which is why it falls within the medicines called antiepileptic drugs. However, since it is a broad-spectrum medicine, with great efficacy on the excitability of the nervous system, since its discovery other uses have been identified; so, for example, it is used as mood stabilizer in bipolar disorderas a preventative migraine and in the treatment of neuropathic pain“, Explain He washed Gonzalezhead of the Neurology and Clinical Neurophysiology service of the Dr. Negrín University Hospital of Gran Canaria, who clarifies that although valproic acid and sodium valproate differ slightly in their chemical structure, the actions of both are practically the same, so they can be considered the same active ingredient.
In general, today these treatments are not chosen as first-line therapies against epilepsy, precisely because of their safety profile, explains the neurologist. Its teratogenic effects in pregnant women were previously known, as well as “the likelihood of liver damage, the effects on the number of platelets, which increases the risk of bruising and bleeding, and the effects on attention, concentration and memory, which makes it possible for children to be associated with learning disorders”. For all these reasons, its use is not prioritized.
“Fortunately, today we have a good number of options for the treatment of seizures with better safety profiles than valproic acid. However, there are circumstances in which seizures are difficult to control, such as in refractory epilepsies, and in this case, valproic acid is one of the alternatives that can help to control them.In addition, there are cases in which a person with epilepsy can have continuous seizures without improvement between them, as occurs in the status epilepticus. In these circumstances, drugs that can be administered intravenously are needed, with valproic acid being one of the most effective for these cases.”