Valproate in pregnancy dips to a record low, NHS data suggest
The latest NHS Medicines and Pregnancy Dashboard, published on 25 September 2025, reveals a continued fall in the use of sodium valproate among women who are pregnant. In the six-month window from October 2024 to March 2025, only five women were prescribed valproate during pregnancy. Crucially, none of these were started on valproate during pregnancy itself. Over the same five months, 75 women stopped taking valproate before conceiving, highlighting a broader shift away from this medication in the childbearing years.
Key numbers and the trend over time
The dashboard also shows that 13,201 women and young females aged 12–54 were prescribed valproate in March 2025. That figure has fluctuated in the early months of 2025, with 12,925 in February and 13,820 in January, but the overarching pattern is a sharp decline compared with 2018. In April 2018, 25,150 women in the 12–54 age group were prescribed valproate, the year when new measures were introduced to curb use in this population. The latest data indicate the long-term strategy to reduce exposure during pregnancy is bearing fruit, even as a small number of cases still occur.
Experts caution that statistics document only part of the picture. While the numbers show a downward trajectory, they do not always reveal the individual clinical reasons behind continuing or stopping treatment, or the risks involved in making a change during pregnancy planning.
What the data mean for safety and treatment choices
Valproate is known to carry risks for pregnancy, including birth defects and neurodevelopmental conditions. The dashboard’s findings align with ongoing efforts to safeguard women and future children, including a pregnancy prevention programme that requires effective contraception and a signed risk acknowledgement form for those who remain on valproate while of childbearing potential.
The role of healthcare teams
Nicola Swanborough of the Epilepsy Society emphasised that while the trend is encouraging, decisions about valproate during pregnancy must be individualized. She noted that for some patients valproate may be the only medication that controls seizures, making the decision to stop particularly challenging. Pharmacists, she added, can be pivotal in ensuring women fully understand the risks and the available alternatives, and in supporting informed choices for themselves and any future children.
Olga Tanda, an advanced neurology pharmacist, outlined how pharmacists across community and hospital settings can improve safety. Each prescription encounter is an opportunity to discuss risk awareness, contraception use, and whether a specialist review or a switch to an alternative therapy has occurred. She also highlighted the growing, yet under-recognised, role of specialist pharmacist prescribers in completing risk acknowledgement forms and guiding conversations about pregnancy risk.
Balancing risk and life circumstances
Some clinicians argue that, in rare cases, the risks of stopping valproate during pregnancy may outweigh the potential fetal risks, particularly where seizure control could be severely compromised. In such scenarios, careful risk-benefit assessments are essential, and the patient’s quality of life and safety must remain central to decision-making.
Patient perspectives and the path forward
Legal scholar Rachel Arkell noted that prescribing data alone cannot capture the full patient experience, because the move away from valproate often involves considering combinations of medicines and their cumulative risks. Epilepsy Action emphasised the importance of providing both women and men with thorough information to support informed treatment choices and effective planning for pregnancy.
What comes next
Health groups welcome the data as a positive step toward enhanced patient safety, but stress that monitoring long-term outcomes remains essential. The Medicines and Healthcare products Regulatory Agency (MHRA) and NHS bodies are urged to publish more comprehensive follow-up on how patients fare after switching from valproate or starting alternative therapies. In the meantime, the message to clinicians is clear: review patient histories promptly, discuss alternatives where possible, and ensure patients are informed about risks and contraception options as part of a shared decision-making process.
