Valproat in der Behandlung von epilepsiekranken Frauen Eine Stellungnahme der Deutschen Gesellschaft für Epileptologie (Valproate for Women with Epilepsy; A Recommendation of the German Chapter of the International League Against Epilepsy)

Abstract There is increasing evidence that intrauterine exposure with Valpraote (VPA) is associated with dose dependent complex teratogenic risks. Newer data suggest that VPA in addition to the well established increased risk for major malformation may contribute to cognitive developmental disorders. These data should still be considered preliminary, nevertheless VPA should be prescribed with great caution in women of child bearing. The decision to discontinue VPA can be very difficult in women who are seizure free under VPA. In these cases the potential teratogenic risks have to be balanced against the risks of seizure recurrence, when VPA is reduced, withdrawn or exchanged against an alternative drug. The German chapter of the International League against Epilepsy has summarised the actual data on VPA-associated teratogenic effects and gives recommendations for various clinical situations considering the epilepsy syndrome, the VPA-dosage, alternative anticonvulsants and psychosocial consequences, and encourages neurologists to contribute to the European Pregnancy Registry (EURAP).