Using valproate in epilepsy
Valproate is licensed to treat epilepsy and bipolar disorder and is also used off-licence to treat other conditions such as migraine. For some patients, particularly those with generalised epilepsy, valproate is the most and sometimes only, effective medication.1 However, if taken by women during pregnancy, valproate is associated with markedly increased risks to the fetus of physical malformations and of neurodevelopmental disorders.2–4
The risk of infertility in men has been outlined in the Summary of Product Characteristics since 2011 although a large retrospective study has been reassuring in this regard.5 Animal studies report ‘testicular toxicity’ and possible transmissibility of autistic-like behaviours induced by valproate in utero between generations.6–8 A recent real-world study based in Norway, Sweden and Denmark, commissioned by the European Medicines Agency (EMA), identified an increased risk of neurodevelopmental disorders in the...
Source: Practical Neurology - Online First Published 28 Oct 2026 Imported 28 Oct 2026 Relevancy: Not reviewed
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