I have cases with severe migraines and repeated kidney stones that precludes topiramate. Use of Valproate would help the migraines but can cause severe deficits in a fetus. European agencies are calling for more extensive restrictions on its use in women.
J Headache Pain. 2018 Aug 14;19(1):68. doi: 10.1186/s10194-018-0898-3.
Latest clinical recommendations on valproate use for migraine prophylaxis in
women of childbearing age: overview from European Medicines Agency and European
Vatzaki E et al
- rate of congenital malformations is 11%
- 30–40% of children exposed experience delays in their early development such as talking and walking later
- IQ is 7-10 points lower
- 3 fold increase in autism
- candidates need to be on a pregnancy prevention programme. I consider Depo-provera the only sufficient agent
Comment – I have severe ADHD cases with severe anger issues on divalproate and it definitely helps with anger control. Once they are old enough to have periods, they are taken off this agent. Not worth the risks.