Epilepsy Drug Linked to Low IQ

[Birdbomb]

http://www.medicinenet.com/script/ma...ticlekey=80910

Epilepsy Drug Linked to Low IQ
Children Whose Moms Took Valproate During Pregnancy More Likely to Have Lower IQs

By Charlene Laino
WebMD Medical News

Reviewed By Louise Chang, MD

May 3, 2007 (Boston) -- Women of childbearing age should avoid taking the commonly prescribed epilepsy drug valproate because of a negative effect on their children's IQ, researchers say.

They found that the intelligence quotient of 2-year-old children was an average of 12 points lower when expectant moms took valproate compared with three other drugs -- Lamictal, carbamazepine, or phenytoin.

In addition, 24% of toddlers born to mothers who took valproate had IQ scores that would put them in the mental retardation range -- that is, below 70 points on the standard IQ test, says Kimford Meador, MD, professor of neurology at the University of Florida in Gainesville.

That compares unfavorably with 9% to 12% for the other drugs, he says.

Valproate -- sold under the brand names Depakote, Depakene, and Depacon -- is one of the oldest and most widely prescribed antiseizure medications on the market.

The three other drugs studied are also widely used: Lamictal; carbamazepine, for which a common brand name is Tegretol; and phenytoin, often sold as Dilantin.

Two more recently approved drugs for epilepsy, Keppra and Topamax, have not been studied with regard to children's IQ, according to Meador.

"We really can't say which drug is best to use in pregnancy, but we can say that valproate should not be used as the first drug of choice by women with epilepsy during childbearing years if at all possible," Meador tells WebMD.

"That said, valproate remains an important treatment option in women who aren't helped by other epilepsy drugs," he says.

If valproate is the only drug that controls a woman's seizures, Meador recommends using the lowest dose possible.

The study was presented here at the annual meeting of the American Academy of Neurology.

Damage During Third Trimester
For the study, Meador and colleagues conducted IQ tests on 187 2-year-olds born to women who had been taking epilepsy drugs.

Meador notes that hundreds of thousands of women of childbearing potential take valproate not only for epilepsy, but also for bipolar disorder and chronic headaches.

Despite the fact that earlier studies also hinted at a negative impact on IQ and found that the drug can cause birth defects, sales went up 20% last year, he says.

The negative impact on IQ occurs in the third trimester, Meador believes. "It's similar to fetal alcohol syndrome. Exposure of the immature third-trimester neonatal brain results in cell loss that is associated with widespread cognitive defects," he explains.

Despite the findings, Meador stresses that pregnant women taking valproate should not just stop taking the drug. "It can be dangerous to switch therapies mid-pregnancy. Talk to your doctor," he says.

Cynthia Harden, MD, professor of neurology at New York Presbyterian-Weill Cornell Medical Center in New York, says though valproate has been linked to lower verbal IQs in the past, the current study was much better designed.

"If we can take a woman off valproate safely as far as seizure control, then we should try not to use it," she tells WebMD.

[Bernard]

Interesting, but not entirely surprising given the recent publicity about the link between valproate and autism.

[Birdbomb]

I am glad my childbearing years are done. It's frightening to think of conceiving a child on any anti-epileptic drug.

[1096]

affect sperm?

[Birdbomb]

1096,

I don't know if these drug studies check on the little spermies, but it's the drugs in the mother's system that does the worst damage. :wink:

[Bernard]

I'm not aware of any studies on anti-epileptic drugs and "swimmers".

[1096]

any studies suggesting sodium valproate can lower the iq of the person taking the medication? or any other anti-epileptic drugs for that matter?

[epileric]

I was on it for decades so it is a little bit of a concern for me.

[Cint]

I was taking Dilantin during both pregnancies and both of my children turned out with High IQs. Both made the Dean's list in college.
Cindy

[Belinda5000]

IDoes anyone know if the meds are supposedly suppose to affect intelligence in childr since they've been taken anti-epileptic drugs since early chilhood?
they always gave me IQ test in elementary school every year.

Belinda

[xenome]

Im confused, how do you do an IQ test on a 2 year old. They dont know anything...

[stilldancing_98]

My son is on Val. There is a difference in IQ. I was on it when I was pregnant. I hate that drug. It is the only one right now that will control his seizures. That is why I am so willing to do neurofeedback now. Tomorrow is my appointment and so I want to bring up all these things with my doc. Alex has birth defects,when he takes tests on meds at school he does not do as well. I did the same when I was on it. A 2 year old, Alex was not able to walk or talk when he was supposed to, I knew there was something wrong.way before the Dr.s told me.

[skillefer]

To answer Xenome, believe it or not, there are special tests to determine IQ's in very young children like 2 year olds. Alot has to do with observation of interactions between the child and parent as well as what the parent reports on when certain stages were met.

The thing is, no drug is 100% safe when it comes to pregnancy...it's a matter of deciding which possibilities you are willing to deal with. That's why my neurologist asked me a looong time ago whether I ever was planning on having kids, and tried to make the med choice based on that. Trust me, if I were a teen, I'd be pushing my parents to look at EEG neurofeedback...but switching to that in the middle of a pregnancy is probably not the best of ideas. And yes, that drop in IQ can occur after birth.

[Eeyore89]

In all honesty as a 19 year old girl, who while not thinking about having children now but sometime, this really upsets me and frankly it does scare me too. I mean I understand that I could have it worse off (I can control my seizures) I don't understand why there are so many restrictions. It's not enough to worry about having a seizure, but we have (women) to worry that our kids could turn out having birth defects b/c we had to keep ourselves healthy? Does this really seem fair? I know that life isn't fair, but we can't help that we have to keep ourselves from having a seizure. We don't take these drugs b/c we want to. We HAVE to. There are still women out there that drink and do drugs during their pregnancy, but they still have children that turn out fine. We didn't ask for this. So why does it have to be like that? I would love my child no matter what, but I don't want them to be challenged. I think I would feel like it was my fault. That I brought this on to an innocent child. Like I said though, I may only be 19, but before I know it I'm going to be married and wanting to have kids and I just am plain scared. It brings tears to my eyes and I wonder why we as epileptics can't catch a break.

[Bernard]

... I could have it worse off (I can control my seizures) ...

There may be hope for you: Stopping drugs when seizures have been controlled for years

[skillefer]

Hi Eeyore! The important thing to remember, is to ALWAYS talk to your doctor and neurologist. For example, studies have shown that if the mother took Folic acid prior to becoming pregnant, the chances of certain birth defects go down. So my neurologist had me taking 600mg. of Folic acid every day, years ago. I'm pregant now...and with a doctor in the family, trust me, I get lots of unsolicited comments about my med switch. *sigh* But the thing is, my OB/GYN sat down and told me, "Look, go home and enjoy the pregancy. Stressing will only hurt the baby." So I did. And my neurologist and I had the discussion on med changing years ago....about 6 years ago to be exact. He said if I ever did get pregnant, he'd rather have me on Dilantin, but that there was no such thing as a 100% safe med. The thing that keeps me sane is remembering that 80% of women on anti-epileptic drug's have perfectly healthy babies. I'd rather pray and believe that Im' in the 80% then stress that I might be in the 20%. Stress can cause complications as well as miscarriage....so I'll stick with being optimistic and full of faith. But you do bring up a very good point. Why hasnt' the pharmaceutical industry come up with a medication for women who are pregant? Probably because of all the different types of seizures and because every body is different. Not every woman would react to the med the same way. And it's weird....believe it or not, some women stop having seizures after they give birth. Weird huh? And others don't have them until after they've given birth....There's just so many variables to consider. The thing is to take care of you. Eat healthy, take care of your body, find ways to deal with stress, excercise, take Folic Acid starting now, and talk to your neurologist about the fact that someday you know you'll probably want to have kids....that way, you are in your best shape, and the doc can put you on a med that is as safe as possible for mom and baby. Trust me, it's a little dicey changing meds during the pregnancy. The funny thing is, that most teen girls never stop to think about whether or not they will want kids in the future, so they just take whatever is prescribed. Talk to your doc, and make the best choices possible. That's all anybody can really do. Totally healthy parents end up with kids with Birth defects or low IQ too.

[alivenwell]

I was placed purely on phenobarbital, the safest known drug at the time. My son turned out fine. He's attending college.

[Eeyore89]

Skillefer,

Thank you so much. I am already taking folic acid, but sometimes reading some of the stuff on websites just scares me a little. You have given me hope that I can have a perfectly healthy baby (when I'm ready) and also that I could stop having seizures. So thank you. I'm called Eeyore for a reason.

[Rach_nc1984]

Im confused, how do you do an IQ test on a 2 year old. They dont know anything...

Hi- special education major here hehe...I actually took a class where I had to conduct 10 assessments on a child. There are actually IQ tests out there that are for babies (Although they are not as reliable or valid as tests for older children) I think "IQ" is what throws people off- intelligence doesn't necessarily have to be related to academics. IQ tests are actually based on what would be developmentally age appropriate for a child at that particular age...So IQ tests for younger children can include things like language, fine and gross motor skills, memory, etc...most of these tests are compared to a norm group (typically developing children) Ok I will get off of my soapbox now hehe

[skillefer]

*chuckle* Hello from a special ed teacher of the last 11 years. And your answer is correct. Especially in that the term IQ throws people off.

IQ is related to innate things. Cognitive assessment (ability testing) is related to things that you need to be taught, like reading, math, writing.