A recent study led by academics from Aston University has highlighted a troubling trend in the use of antiseizure medications globally. Conducted in collaboration with the World Health Organization (WHO), the research reveals that while access to these essential medications has increased in low- and middle-income countries, the prescribing practices may not always prioritize safety. The study, which analyzed data from 73 countries between 2012 and 2022, indicates a rise in prescriptions, yet raises alarms over the potential risks associated with the most commonly prescribed drug, valproate.
The findings underscore a dual reality: while the expanded access to antiseizure medicines is a positive development for patients who previously faced limited treatment options, the widespread use of valproate is concerning. This medication has been linked to serious birth defects and neurodevelopmental issues in infants if taken by women during pregnancy. Notable risks include spina bifida, cleft palate, and various intellectual and behavioral disorders. Recognizing these dangers, the WHO has classified valproate as an “essential medicine” but has also issued specific guidance advising against its prescription to women and girls of childbearing age due to the high risk of fetal harm.
Concerns Over Global Prescribing Practices
The research conducted by Dr. Aadrienne Chan and Professor Ian Wong points to significant disparities in safe prescribing practices worldwide. In high-income countries, stricter regulations and dedicated pregnancy prevention programs have successfully curtailed the use of valproate. Conversely, in regions where access to newer, safer antiseizure drugs is limited, valproate remains the primary option for many patients.
Dr. Chan emphasized the need for improved education on the risks associated with valproate and the importance of prescribing alternative medications where appropriate. “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. But the continued widespread use of valproate in some parts of the world is concerning, given its known risks during pregnancy,” she stated.
The WHO commissioned this study to better understand and promote the safe and equitable use of essential neurological medicines globally. The results were published in the journal eClinicalMedicine, where they contribute to ongoing discussions about the safe use of these critical medications and the need for consistent practices across different healthcare systems.
Next Steps for Research and Policy Improvements
The researchers utilized sales data from the relevant countries to draw conclusions about the use of antiseizure medications. However, they recognize that future studies must focus on understanding specific population patterns and assessing how safety measures are implemented in various regions. This deeper analysis will be crucial in determining whether these drugs are being prescribed appropriately to women of childbearing age and evaluating the associated risks to unborn children.
As the global health community continues to grapple with the balance between access to essential medications and patient safety, the findings of this study serve as a clarion call for greater alignment on safe prescribing practices and enhanced education. By addressing these issues, stakeholders can help protect future generations from the potential harm associated with antiseizure medications like valproate.
