A recent study led by academics from Aston University and commissioned by the World Health Organization (WHO) reveals a troubling increase in the global use of antiseizure medication, particularly valproate, which has been linked to serious birth defects. The research spans a decade, from 2012 to 2022, and covers data from 73 countries. While the findings indicate improved access to essential neurological medications in low- and middle-income countries, the safety of prescribing practices raises significant concerns.
The study, conducted by Dr. Adrienne Chan and Professor Ian Wong, highlights that although more patients are receiving treatment for seizure disorders, the most commonly prescribed medication, valproate, poses risks for pregnant women. If taken during pregnancy, this drug can lead to conditions such as spina bifida, cleft palate, and various neurodevelopmental challenges including memory and communication disorders.
Global Disparities in Treatment Practices
The WHO has classified valproate as an “essential medicine,” yet it has also issued guidance against its use among women and girls of childbearing age due to the potential for birth defects. The organization has identified valproate-related fetal disorders as a pressing global issue, underscoring the need for improved educational efforts to inform healthcare providers about the associated risks.
In high-income countries, stricter regulations and pregnancy prevention programs have successfully reduced the use of valproate. In contrast, many low- and middle-income regions continue to see a higher frequency of its prescription, often due to the limited availability and affordability of newer antiseizure medications. This disparity highlights the need for a more equitable approach to prescribing practices around the world.
Next Steps for Research and Policy
The researchers utilized sales data to analyze medication trends, but they emphasize the necessity of delving deeper into specific population patterns and the implementation of safety measures across diverse regions. Understanding how these medications are prescribed to women of childbearing age will be crucial in assessing risks to unborn children.
Dr. Chan noted, “Our findings show that access to antiseizure medicines is expanding globally, which is good news for patients who previously had little or no treatment options. But the continued widespread use of valproate in some parts of the world is concerning, given its known risks during pregnancy. Greater global alignment on safe prescribing and education is urgently needed to protect future generations.”
The study results are published in eClinicalMedicine, and they represent a critical step toward understanding the patterns of antiseizure medication consumption worldwide. Addressing the challenges associated with valproate is essential for safeguarding the health of mothers and their children in the years to come.
