Antiepileptic Exposure in Utero and Preschooler Development: Levetiracetam vs. Valproate — Physician’s First Watch
Antiepileptic Exposure in Utero and Preschooler Development: Levetiracetam vs. Valproate
By Amy Orciari Herman
Prenatal exposure to the antiepileptic levetiracetam (brand name, Keppra) appears safer than valproate in terms of developmental outcomes in preschool-aged children, according to an industry-funded study in Neurology.
Researchers assessed roughly 100 children aged 3 to 4.5 years whose mothers had taken levetiracetam or valproate during pregnancy, as well as 130 control children whose mothers did not have epilepsy (and therefore didn't use antiepileptics). Language and development scores did not differ between children exposed to levetiracetam and controls. In addition, those exposed to levetiracetam had higher scores for gross motor skills, comprehension language, and expressive language than those exposed to valproate.
Current guidelines suggest that valproate should be avoided, if possible, in women of childbearing age. The study authors point to a 2013 study showing a low rate of congenital malformations among children exposed to levetiracetam. They conclude that levetiracetam "may be a preferential antiepileptic drug ... during pregnancy if seizures can be controlled."