Valproate Unsafe for Migraine Prevention During Pregnancy

by Teri Robert, Lead Expert

What medications can be taken for Migraines during pregnancy is of vital concern to many Migraineurs. This can be a very difficult issue as many medications fall into the FDA's pregnancy category C. These medications do not have enough data collected to fully evaluate their effects on a developing fetus. Thus, the decision of whether or not to take them during pregnancy is generally based on weighing the risks against the benefits.

New guidelines developed by the American Academy of Neurology and the American Epilepsy Society are being released today. They show that while it’s relatively safe for women with epilepsy to become pregnant, caution must be taken. These guidelines are the result of systematic review of relevant articles published between January, 1985, and June, 2007.

The guidelines recommend women with epilepsy avoid taking the drug valproate (Depakene, Depakote) during pregnancy. The guidelines also recommend that, whenever possible, women with epilepsy should not take more than one neuronal stabilizing agent at a time during pregnancy since taking more than one seizure drug has also been found to increase the risk of birth defects compared to taking only one medication.

Lead guideline author Cynthia Harden, MD, Director of the Epilepsy Division at the University of Miami’s Miller School of Medicine and member of the American Academy of Neurology commented:

“Good evidence shows that valproate is linked to an increased risk for fetal malformations and decreased thinking skills in children, whether used by itself or with other medications... Overall, what we found should be very reassuring to every woman with epilepsy planning to become pregnant.. These guidelines show that women with epilepsy are not at a substantially increased risk of having a Cesarean section, late pregnancy bleeding, or premature contractions or premature labor and delivery. Also, if a woman is seizure free nine months before she becomes pregnant, it’s likely that she will not have any seizures during the pregnancy.”1

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