April 17, 2009

Lower IQs In Offspring Of Moms Taking Depakote

There's a highly discouraging study out in the New England Journal of Medicine in which researchers assert that the widely used anti-seizure drug Depakote (valproate in generic form) is leading to significantly lower IQ scores in children whose mothers took the drug while pregnant with the child. The drug is widely used as an epilepsy treatment and as a so-called mood stabilizer in bipolar disorder. Worldwide, Depakote generated $1.364 billion in sales in 2008 for its maker, Abbott Labs. It's not clear to me how much revenue the drug generates in generic form. (Full disclosure: I was once a sales rep for Abbott Critical Care Systems, the company's smallest division, in the late-1980s.)

The study was of offspring of moms who took the drug for epilepsy, but it's difficult to imagine anyone arguing that the same issues wouldn't be present in moms who took the drug for bipolar disorder (but I'm sure someone will try).

Offspring of moms who took Lamictal had IQ scores at age 3 of 101; 99 for phenytoin; 98 for carbamazepine; and, 92 for Depakote.

As one researcher told the AP:

"'We've known this drug is a bad actor for a long time,' said Dr. Lewis Holmes, director of the North American Antiepileptic Disease Pregnancy Registry, based at Massachusetts General Hospital in Boston.

"The new study is important because it's the largest to show a connection between valproate and diminished IQ. Its publication in the prestigious New England Journal of Medicine should alert physicians who until now have ignored the drug's potential dangers to fetuses, added Holmes, who was not involved with the study."

Depakote has also been tied to ovarian cysts and menstrual irregularities. A small British study last year linked use of the drug in utero to autism in offspring.

Posted by Philip Dawdy at April 17, 2009 12:03 AM
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Comments

Teenscreen... TMAP... medicating soccer moms... mothers to be... now the unborn.
Do these drugs give the wee ones Tardive Dyskinesia, a kind of St. Vitus' Dance in the womb, too?

Posted by: Lilly NC at April 17, 2009 12:57 AM

You've got taken.

This has been known since the 1980's at least. The issue that they're trying to cover is lamictal causes mental retardation too and GSK knew it before it was marketed (animal studies and mechanism same as valproate). A possible reason it's higher with valproate is because it's a combination with others and valproate inhibits epoxide hydrolase. (The others form epoxides including lamictal.)

Funny how this didn't start coming out until lamictal is going off patent.

Posted by: Salmon at April 17, 2009 06:49 AM

Phil do you know off-hand what a "normal" IQ would be for a 3-year-old?

In the article I read on the study it did not list a normal IQ so I could not figure out how much or if the other drugs effected a child's IQ.

Posted by: Evelyn Pringle at April 17, 2009 09:03 AM

Dr Healy is a hero..
Honest, ethical and truthful..
Rare for a psychiatrist..

Posted by: truthman30 at April 17, 2009 05:12 PM

Hey Salmon,

That's what I suspected, especially when the article I read didn't compare the other drugs to a normal IQ. Can you tell me what normal IQ would be?

Cheers,

Evie

Posted by: Evelyn Pringle at April 17, 2009 06:59 PM

truthman30:

Dr. Healy supports the use of ECT to treat psychiatric illnesses. In fact, he co-wrote an entire book about ECT in which he lamented the fact that it is not used often enough, especially given its evidence base. Do you still think he is "honest, ethical and truthful"?

Posted by: dguller at April 17, 2009 07:47 PM

Healy is honest about most everything, even thoughhe has taken Pharma money. ECT has caused great and permanent harm and even death - in a member of my immediate family back when death from it was common. Don't know how common memory loss is today. However, in REAL manic depression, if suicidal/psychotic depression just won't quit, for days and weeks on end - now that hospitals are in and out affairs for the most part, and humane home help is almost impossible to find, and humane day programs won't usually take someone this ill plus they are usually self-pay, and Soteria Houses were done away with, so it all falls on the famiy: collapse or suicide may be the only alternatives to ECT. In that sense, it is humane. As seen with my own eyes...do you think it would have been the first pick of my suffering family member and me, knowing someone of the next older generation who was killed by it. No, not defending coercion, ever, by any means. And not ruling out possible memory or other impairment if done too often or wrong or whatever.

Posted by: sorrowful at April 17, 2009 08:50 PM

Dr.Peter Breggin,the dangers of ECT:

"Animal studies show diffuse brain damage following ECT: the most common findings are petechial or pinpoint hemorrhages throughout the brain and surrounding blood vessels, as well as areas of gliosis and neuronal degeneration, with patches of cell death (ghost cells and neuronophagia). Occasionally larger hemorrhages and edema of the brain are found. These findings are also seen on human autopsies performed on ECT patients."

Posted by: anonymous at April 17, 2009 11:17 PM

In an extreme situation, such as described above it becomes a choice of life (albeit with the chance of mild-moderate(?) impairment - saw none in my child post ECT )- or certain death, we opted for life. But this level of severity is very rare. The other people I met getting ECT did not have similar pre-ECT stories to tell...

Posted by: sorrowful at April 18, 2009 08:09 AM
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