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Study: Seizure Medication Used During Pregnancy Linked to ADHD in Children

A new study of nearly a million children in Denmark shows increased incidences of ADHD in the offspring of mothers who used the medication Valproate during pregnancy, however it also raises unanswered questions about the ADHD-epilepsy connection, dosage variations, and the treatment of multiple comorbid conditions.

Reviewed on May 16, 2019

It is well known that attention deficit disorder (ADHD or ADD) is hereditary, however new evidence shows that external factors may also increase its prevalence in children.

A recent study1 in Denmark suggests a link between maternal use of the anti-epileptic drug Valproate during pregnancy and the development of ADHD in those mothers’ offspring. Even after adjusting for a range of factors such as maternal health and age, the study concluded that in utero exposure to Valproate caused a child’s risk of developing ADHD to increase 48%, according to the population-based cohort study published in JAMA Network Open by Danish researchers.

Of the 912,722 children studied who were not exposed to the drug, 3.2% developed ADHD. Of the 580 children exposed to Valproate in utero, 8.4% developed ADHD. Exposure in the first trimester of pregnancy resulted in a 52% higher risk of ADHD compared to children who were not exposed; the risk of developing ADHD dropped to 22% for children exposed after the first trimester. Other antiepileptic drugs, such as clonazepam, did not cause an increased risk of ADHD.

Valproate, which is prescribed for bipolar disorder and migraines in addition to epilepsy, taken during pregnancy is increasingly being linked with multiple adverse neurodevelopmental outcomes, including autism and congenital malformations.

The study has a number of limitations. Namely, it did not sufficiently probe whether the maternal health condition(s) that warranted the prescription of Valproate could also explain the increased risk of ADHD, the varying dosages of Valproate taken by the women studied, or other medications taken by the mother might have increased the child’s risk for developing ADHD. Nonetheless, medical professionals should discuss these findings with female patients who are considering Valproate.

Footnotes

Jakob Christensen, Lars H. Pedersen, Yuelian Sun; et al. “Association of Prenatal Exposure to Valproate and Other Antiepileptic Drugs With Risk for Attention-Deficit/Hyperactivity Disorder in Offspring.” JAMA Network Open. (January 2019) Vol. 2, No. 1.

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