Is valproate contraindicated in young women with epilepsy? YES

The purpose of this article is to highlight and discuss why valproate should be used with great caution, or whenever possible be avoided, in the treatment of young women. Valproate has been shown to cause polycystic ovary syndrome in a substantial proportion of young women if treatment is initiated before the age of 26. Furthermore, use of valproate during pregnancy has been associated with major congenital malformations in the offspring that are higher than after exposure to other antiepileptic drugs. Recent data have also shown that exposure to valproate in utero can adversely affect the cognitive development of the child. For these reasons, valproate is best avoided in the treatment of young women with epilepsy when other alternatives are available.