Depakote During Pregnancy & Breastfeeding
Summary
Women who are pregnant or plan to get pregnant should avoid the use of Depakote (Divalproex sodium) unless their physician determines that the benefits of the treatment clearly outweigh the potential risks. This is typically only true in severe cases of epilepsy where seizures could pose even more harm to the unborn child than the risks associated with Depakote, and also place the mother in danger.
Taking Depakote during pregnancy or just prior to becoming pregnant could result in irreversible birth defects, anencephaly (a condition where a large portion of the brain is missing at birth, leaving the child deaf, blind, and often unconscious), and spina bifida.
Should a Pregnant or Breastfeeding Woman Take Depakote?
Pregnancy and breastfeeding may be considered contraindicated against Depakote, depending on the risks involved.
If the doctor sees that the benefits of having the mother take the drug outweigh the risks, then it may be administered. However, if it’s the other way around, Depakote will not be given. For example, if the woman’s seizures are so strong and frequent that her own life and that of her child may be put at stake if medication is withheld, Depakote will be prescribed. When the seizures are mild and do not occur very often, then the doctor may opt not to administer the medicine as to protect the fetus.
Depakote as a Pregnancy Category D Drug
Depakote being advisable or inadvisable to pregnant and breastfeeding women has something to do with the drug’s classification as Pregnancy Category D under the U.S. Food and Drug Administration. All drugs are assigned a certain category by the FDA to serve as a system that health professionals can use in determining whether or not certain drugs may be prescribed to pregnant women.
According to the U.S. FDA website, “Drugs in Pregnancy Category D have human data demonstrating evidence of human fetal risk, but the potential benefits of these drugs may still be considered acceptable in certain situations.”
Why is Depakote Contraindicated?
When possible, doctors will always choose not to prescribe Depakote to a pregnant or breastfeeding woman because of the high incidence of birth defects associated with the drug’s use. Some of these abnormalities include holes in the heart and spine, abnormal skull formation, cleft palate, and poor cognitive development.
Breastfeeding
Because Depakote passes through breast milk, it is also often contraindicated against breastfeeding. However, there are no definitive studies establishing the effects of the drug on infants who are breastfed by mothers under Depakote treatment. It is thus not uncommon to hear about women taking the drug while breastfeeding, but not during pregnancy.
Why it is Important to Control or Treat Seizures
Doctors sometimes choose to take risks with the fetus by prescribing Depakote to the mother only if it is for their protection. This is because epileptic seizures can have fatal consequences when untreated.
If the epileptic mother does come out alive, her untreated seizures may cause permanent brain damage, more seizures, disease progression (when the seizures are brought about by an existing chronic condition) or severe depression. Unless the seizures are considered to be mild, controllable, and non-life threatening, medication should be given even to a pregnant or breastfeeding woman.
If you are currently on Depakote and would like to bear a child, plan your pregnancy and inform your doctor about it. Many lawsuits have been filed against physicians who prescribed Depakote to pregnant women, not knowing at first that they were pregnant. If you want to avoid legal troubles, as well risks to your own life and that of your future child, be transparent with your doctor and choose a doctor that you fully trust.
