A recent study conducted by researchers from Aston University, in collaboration with the World Health Organization (WHO), has revealed a significant increase in the use of antiseizure medications across the globe. While this trend suggests improved access to essential neurological treatments in low- and middle-income countries, it raises serious safety concerns regarding the prescription practices of these medications.
Between 2012 and 2022, Dr. Adrienne Chan and Professor Ian Wong analyzed data on antiseizure medication usage across 73 countries. Their findings indicate that although more patients are receiving treatment, the most commonly prescribed drug, valproate, is associated with serious risks for pregnant women. Valproate has been linked to a range of birth defects, including spina bifida, cleft palate, and various neurodevelopmental disorders, which can affect a child’s intellectual and behavioral development.
The WHO recognizes valproate as an “essential medicine,” yet it has issued guidelines specifically advising against its use in women and girls of childbearing age due to the heightened risk of birth defects. The organization has identified valproate-related fetal disorders as a pressing global health issue, underscoring the need for improved prescribing practices worldwide.
Disparities in Prescribing Practices
Research by Dr. Chan and Professor Wong highlights stark disparities in the safe prescribing of antiseizure medications. In high-income countries, stricter regulations and effective pregnancy prevention programs have contributed to a decline in valproate prescriptions. Conversely, in many low- and middle-income nations, where newer and safer antiseizure drugs are either unavailable or prohibitively expensive, valproate remains the go-to medication for many doctors.
The WHO commissioned this study as part of ongoing efforts to promote the safe and equitable use of neurological medicines. The results were published in eClinicalMedicine, emphasizing the need for further investigation into specific population trends and the implementation of safety measures.
Next Steps for Research and Policy
The researchers utilized sales data from the analyzed countries, but they now aim to delve deeper into understanding prescription patterns among specific demographics. Future research will focus on how safety protocols are being applied in various regions, particularly regarding the prescription of antiseizure drugs to women of childbearing age and the implications for unborn children.
Dr. Chan stated, “Our findings show that access to antiseizure medicines is expanding globally, which is good news for patients who previously had little or no treatment options. However, the continued widespread use of valproate in some parts of the world is concerning, given its known risks during pregnancy. Greater global alignment on safe prescribing and education is urgently needed to protect future generations.”
The study underscores the critical importance of education for healthcare professionals and patients alike regarding the risks associated with antiseizure medications, particularly valproate. As access to these essential drugs improves, ensuring their safe use must remain a priority to protect vulnerable populations and promote better health outcomes globally.
