A recent paper in The Lancet Neurology titled “Birth defects after prenatal exposure to anti-epileptic drugs” highlights the fact that use of antiepileptic drugs containing sodium valproate (Depacon, others) during pregnancy is correlated with an increased for birth defects, especially when AEDs are used during the first trimester.
In the past, collaborative multinational studies have set out to compare the risk for MCAs between different AED treatments and the results have been consistent with the leading theories in the medical world: monotherapy used with commonly used AEDs has a positive correlation with increase risk of MCAs and the risk is even greater when exposed to polytherapy.
There is no evidence currently that suggest that epilepsy alone is associated with an increase in risk of MCAs, but exposure to valproic acid is connected to elevated risks of MCAs. Studies done on valproic acid have confirmed dose-dependency. Doses above 800-1000 mg per day have shown to increase risk of MCAs. Data obtained from the North American registry suggests that Phenobarbital, a nonselective central nervous system depressant, may have a higher teratogenic risk compared with AEDs (but not compared to valproic acid, a chemical consistently found to be the most dangerous of its kind). However, accurate and dependable information about the newer generations of AEDs are not yet available. In the study of an anticonvulsant called Lamotrigine (Lamictal), a connection between maternal dose and rates of MCAs was found.
There are still large gaps in knowledge about AEDs that collaborative pregnancy registries around the world are trying to fill. Some of the remaining issues these agencies are trying to address in the future are comparative risks that are connected with Phenobarbital and with specific AED combinations. Hidden factors of these drugs are also being tested with the interaction of AED-associated risks with genetic profiles. With the completion of large scale studies, we may have a better understanding of whether specific AEDs have the ability to cause specific anomalies.
Due to the fact that the manufacturer of Depacon, a widely-used AED containing valproic acid, has failed to inform women of the risks Depacon use carries for developing babies, Depacon lawsuits have been filed around the country.
If you or a loved one used Depacon during pregnancy and your child was born with a congenital abnormality, please do not hesitate to contact our team of Depacon lawyers for a free case consultation.