Pregnant epileptic women should be able to control their seizures with antiepileptic drugs (AEDs) without risking their child’s cognitive development. Now, researchers have found that the newer AEDs Keppra (levetiracetam) and Topamax (topiramate) may not have a negative impact on the baby’s IQ and thinking skills when taken during pregnancy.
However, there is increasing evidence the same is not true for the medication Depakote (valproate).
The study, conducted in children between the ages of 5 and 9 born to epileptic women, was published by U.K. researchers in the journal Neurology, titled “Cognition in school-age children exposed to levetiracetam, topiramate, or sodium valproate.”
Several studies indicate that children born to women who took Depakote during pregnancy are at risk of having birth defects, developmental problems, and lower IQ, especially at higher dosages. However, few studies have looked at the effects of newer AEDs such as Keppra and Topamax on child development and thinking.
Researchers used data from the UK Epilepsy and Pregnancy Register to identify 42 women that had taken Keppra during pregnancy; 27 who had taken Topamax; and 47 who had taken Depakote. They assessed several cognitive parameters to measure the IQ, verbal and non-verbal comprehension, and the speed in processing visual information of children born to these women. They compared these results with those of the control group: children born to 55 women who did not take AEDs during pregnancy.
The researchers concluded that the children of women who took Keppra or Topamax did not have reduced IQs or other thinking skills compared to the control group. Moreover, they also confirmed poorer performance for children exposed to higher doses of Depakote compared to children exposed to higher doses of Keppra or Topamax. These children were found to have the lowest IQs, scoring an average of 11 points lower on the IQ test, which has an average of 100 points. There was a threefold increase of children below the average range on the IQ score born to mothers who took Depakote.
The team is aware that they have studied few women with epilepsy and that increasing the number of participants is essential for a more representative picture of all women with epilepsy.
“While our findings represent a promising start, larger studies need to be done to ensure that these drugs will not change the thinking abilities of children,” study leader Dr. Rebecca Bromley said in a press release.