Valproate teratogenic effects

Teratogenic effects in developing fetuses such as neural tube defects may occur with valproate use... 

Janas MS, Arroe M, Hansen SH, Graem N. Lung hypoplasia—a possible teratogenic effect of valproate. Case report. APMIS 1998 106(2) 300-4. 

A rare complication is fulminant hepatitis. Children <2 years of age with other medical conditions who were given multiple antiseizure agents were especially likely to suffer fatal hepatic injury there were no deaths reported for patients >10 years old who received only valproate. Acute pancreatitis and hyperammonemia have been associated with the use of valproic acid. Valproic acid can produce teratogenic effects such as neural tube defects. 

Carbamazepine is an anticonvulsant beneficial in the treatment of bipolar I disorder, and, as in the case of valproate, it may be more advantageous than lithium in non-classical bipolar conditions such as mixed mood states and rapid cycling conditions. It appears to have a teratogenic effect and, like valproate, has been associated with an increased risk of neural tube defects. ... 

Diav-Citrin O, Shechtman S, Bar-Oz B, Cantrell D, Arnon J, Ornoy A. Pregnancy outcome after in utero exposure to valproate evidence of dose relationship in teratogenic effect. CNS Drugs 2008 22(4) 325-34. 

All new information on the teratogenic effects of the most frequently used antiepileptic drugs has been reviewed [61 ]. T e prevalence of major congenital malformations associated with exposure to carbamazepine or lamotrigine was only marginally increased from expected, while malformation rates with valproate have been reported to be 2-4 times higher. This adverse outcome appears to be dose-related. 

Valproate, carbamazepine, and other anticonvulsants pose teratogenic risks. Despite this, treatment should continue during pregnancy, as the potential threat to the fetus by a seizure is greater However, it is mandatory to administer the lowest dose affording safe and effective prophylaxis. Concurrent high-dose administration of folate may... 

Bojic, U., Elmazar, M.M.A., Hauck, R.-S. and Nau, H. (1996) Further branching of valproate-related carboxylic acids reduces the teratogenic activity, but not the anticonvulsant effect. Chem. Res. Toxicol., 9, 866-870. 

Kola, L Folb, P. 1. An assessment of the effects of cyclophosphamide and sodium valproate on the viabihty of preimplantation mouse embryos using the fluorescein diacetate test. Teratogen., Carcinogen, Mutagen. 1986,6, 23-31. 

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