Epilepsy medication during pregnancy linked to increased risk of psychiatric disorders in children

Some types of epilepsy medications taken during pregnancy are associated with an increased risk of serious psychiatric disorders in children.

This is the conclusion of a comprehensive study of 38,000 children of mothers with epilepsy by researchers at Aarhus University. The research was published in the journal JAMA Neurology.

While it has long been known that some forms of epilepsy medication used during pregnancy are associated with a risk of birth defects, this new study is the most comprehensive study of childhood mental health yet.

Among other things, researchers found a troubling link between the antiseizure drug valproat and a child’s risk of developing several different psychiatric disorders.

“Our study shows that four out of 10 children born to mothers with epilepsy who used valproate during pregnancy were diagnosed with a psychiatric disorder before the age of 18, and that the drug was particularly associated with an increased risk of conditions such as autism, ADHD and intellectual disability,” explains Jakob Christensen, professor at Aarhus University and consultant at Aarhus University Hospital and one of the researchers behind the study.

Warning against various drugs

In the study, 42% of the children of mothers who used valproate during pregnancy developed a psychiatric disorder before age 18. In comparison, only 31% of children born to mothers with epilepsy who did not take anticonvulsants during pregnancy developed a psychiatric disorder.

The study also shows that children whose mothers took the drugs topiramate or levetiracetam during pregnancy have an increased risk of ADHD and anxiety disorders.

On the positive side, the study shows that commonly used drugs such as lamotrigine, carbamazepine and oxcarbazepine are not associated with an increased risk of psychiatric disorders.

Need for more research

According to Jakob Christensen, the study confirms the existing warning against the use of valproate during pregnancy and also recommends caution with the use of topiramate and levetiracetam.

“Our research emphasizes the importance of understanding the potential harmful effects of epilepsy medications during pregnancy and the continuing lack of knowledge about how different types of medications can affect a child’s psychological development,” he says, and continues:

“Our study shows that there is a need for more research and more accurate risk estimates to help pregnant women with epilepsy and their physicians make informed decisions about medication use during pregnancy.”

The study was carried out in five Nordic countries – Denmark, Sweden, Norway, Finland and Iceland – and includes children born in the period 1996-2017.

In Denmark approx. 400 children are born every year to mothers who took medication for epilepsy during pregnancy.