The anti-epilepsy drug valproate should be avoided whenever possible in women who may become pregnant due to a high risk of malformations and developmental problems in babies who are exposed to the drug before birth.

The guidance comes from a joint task force of the Commission of European Affairs of the International League Against Epilepsy and the European Academy of Neurology.

In an Epilepsia paper, the task force notes that it is also important that those women who need valproate to control their seizures are not denied the most effective treatment, as uncontrolled seizures can have serious consequences.

The experts' recommendations are based on risk-benefit assessments of different treatment alternatives in various clinical situations, considering teratogenic risks associated with use valproate and treatment alternatives, patient and fetal risks associated with seizures, and the effectiveness of various therapies against different types of epilepsy.

"The choice of treatment for a woman of childbearing potential should be based on a shared decision between clinician and the fully informed patient," said lead author Dr. Torbjörn Tomson.