A new study finds that the epilepsy drug levetiracetam appears not to be associated with thinking, movement and language problems for preschool children born to mothers who took the drug during pregnancy, although the drug valproate was associated with some difficulties in preschoolers. The study is published in the January 8, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology.
"These results are heartening, as the use of levetiracetam has increased in recent years, but there has been limited information on its effect on the thinking, movement and language abilities of children. However this is the first study to look at the effects of levetiracetam and further research is needed before we can be certain there are no associations. It is very important that women do not stop taking their medication before speaking to their healthcare professional," said study author Rebekah Shallcross, PhD, of the University of Liverpool in the United Kingdom.
The study involved 53 children exposed to levetiracetam, 44 children whose mothers took valproate and 151 children whose mothers did not have epilepsy and did not take any drugs during pregnancy. The children were age three to four-and-a-half. Tests evaluated their development in areas such as thinking, movement and language abilities.
The study found that children exposed to levetiracetam did not differ from children not exposed to epilepsy drugs on any scale administered. Children who were exposed to valproate, however, scored an average of 16 points lower on movement tests, 10 points lower on expressive language tests and six points lower on language comprehension measures than those exposed to levetiracetam.
In a corresponding editorial, Pavel Klein, MB, BChir, of the Mid-Atlantic Epilepsy and Sleep Center in Bethesda, Md., said, "Importantly, valproate is used more commonly for treatment of neuropsychiatric diseases such as bipolar affective disorder or migraines, than for epilepsy. In 2005 to 2007, only 19 percent of the 926,000 valproate prescriptions given to women in the U.S. between the ages of 15 and 44 years were for seizures. There is virtually no information about the drug's effect on babies born to mothers taking the drug for these disorders." Klein noted that valproate doses used in these disorders are usually lower than for epilepsy.
- R. Shallcross, R. L. Bromley, C. P. Cheyne, M. Garcia-Finana, B. Irwin, J. Morrow, G. A. Baker. In utero exposure to levetiracetam vs valproate: Development and language at 3 years of age. Neurology, 2014; DOI: 10.1212/WNL.0000000000000030
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