A new study has used national level electronic health records to track use of sodium valproate in men and women across England and Wales.
Study authors Dr Caroline Dale and colleagues found that use of the medicine sodium valproate has declined in women during and outside of pregnancy between 2019 and 2023.
Sodium valproate is used to treat epilepsy, bipolar disorder and migraines. For some people with epilepsy, it can be the only medication that is effective.
However, it has been linked to problems in babies exposed to the medication during pregnancy, including birth defects and learning and development problems, and was at the centre of a scandal.
Policy changes in 2018 limited prescriptions of this medicine in women of childbearing potential and introduced the pregnancy prevention programme.
However, existing data are not enough to show the use of sodium valproate by women of childbearing potential or during pregnancy. They also don’t show the effects of the COVID-19 pandemic in implementing the policy changes, the authors write.
The study was able to identify sodium valproate use trends through linking information from electronic health record data sources.
The authors write: “With improved access to electronic health data with coverage of the whole population, the effect of policy changes and their consequences can be more reliably tracked.”
The findings
The researchers found that the current and new use of sodium valproate decreased over the study period (2019-2023). The new use of sodium valproate in men also decreased during the study period, but remained at much higher levels than for women.
The new use of sodium valproate reduced from seven to five women per 100,000 aged between 15-19 years between 2019 and the end of 2022. In women aged 20-29, the use fell from 11 to seven, and in women aged 30-39, it fell from 15 to seven.
The number of women given sodium valproate during pregnancy also fell from six in 1,000 to 5.2 in 1,000. The total number of women given sodium valproate fell from 140 in 2019 to 85 in 2023.
In men, the new use of sodium valproate also reduced from 53 to 43 per 100,000 men aged 15-19 years. The number fell from 59 to 47 in 20-29-year-olds and fell from 57 to 42 in 30-39-year-olds.
The study also concluded that “no clear evidence was found that deaths related to epilepsy increased in women aged 15-49 during 2015-22, but a slight increase was found in men during the later period between April 2018 and December 2022”.
The researchers said further studies should focus on people who had switched away from sodium valproate to understand effects on seizure control and contributing factors. They should also investigate the rise in deaths related to epilepsy in men, they added.
More articles
