The latest data on valproate in pregnancy
A new update from the NHS Medicines and Pregnancy Dashboard, published on 25 September 2025, shows a continued drop in the use of sodium valproate by women of childbearing age and a very small number of pregnancies affected by the drug. Between October 2024 and March 2025, five women were prescribed valproate while pregnant, and none started the medication during pregnancy. In the same five-month window, 75 women stopped taking valproate before conceiving.
The dashboard also reports that 13,201 women and young females aged 12–54 were prescribed valproate in March 2025, with 12,925 in February 2025 and 13,820 in January 2025. These figures have almost halved since April 2018, when 25,150 women and girls in this age group were prescribed valproate after new safety measures were introduced to curb its use among those who might become pregnant.
Understanding the numbers and what they mean
The data are presented alongside a figure showing trends in pregnancies affected by valproate, illustrating a decline in exposure over time. Health experts stress that even as the numbers fall, the risks associated with valproate during pregnancy—such as birth defects and neurodevelopmental conditions—remain significant considerations for clinicians and patients alike.
Why the risk remains a focal point
Valproate has long been linked to risks for the fetus, prompting regulatory and professional bodies to push for stricter prescribing practices and stronger pregnancy prevention measures. For some women, valproate may be the only medication capable of controlling seizures, making decisions highly individualized and complex. In such cases, the potential benefits for the mother must be weighed against the potential harms to the unborn child.
Expert voices on the current trend
Nicola Swanborough, head of external affairs at Epilepsy Society, welcomed the downward trend: “We are pleased to see that the number of women prescribed valproate is reducing and would hope that those still taking the medication are enrolled in the pregnancy prevention programme.” She emphasized that some patients face hard choices where stopping the drug could raise seizure risk, and noted that pharmacists can play a pivotal role in educating patients about risks and contraception. Swanborough also called for MHRA (Medicines and Healthcare products Regulatory Agency) to report longer-term outcomes for patients who switch from valproate or who start alternative therapies.
Rachel Arkell, a legal academic, cautioned that statistics tell only part of the story, pointing out that known risks may push patients toward other drug combinations with their own uncertainties. She underscored the importance of informed decision-making in scenarios where changing treatment affects daily life and pregnancy planning.
Olga Tanda, an advanced neurology pharmacist, outlined how pharmacists can strengthen safety across settings. In community pharmacies, every prescription for women of childbearing age is an opportunity to discuss risks and contraception; in hospital settings, pharmacists and technicians can verify understanding and ensure risk forms and specialist guidance are up to date. She noted that specialist pharmacists should have a more visible role in driving these conversations and reviews, not just relying on neurology consultants.
Patient-centered care and informed choices
Alison Fuller of Epilepsy Action emphasised that collecting data on valproate prescribing is a positive step toward safer care. She highlighted that birth defects and neurodevelopmental concerns loom large in the public conversation and stressed the need for both women and men to receive clear, balanced information to make informed treatment choices. The overarching goal is to reduce exposure in pregnancy while ensuring epilepsy management remains effective for those who need it.
What this means for patients and clinicians
For patients currently on valproate, clinicians should continue individual risk assessments, discuss contraception and pregnancy planning, and explore alternative therapies where possible. The data underscore the importance of ongoing review, informed consent, and shared decision-making among patients, their families, and their healthcare teams. As regulators monitor long-term outcomes, the medical community remains focused on safeguarding both maternal health and fetal development, while acknowledging the real-world challenges of epilepsy management.
Looking ahead
Future dashboards are expected to shed more light on long-term outcomes for those who switch from valproate or have pregnancies affected by the drug. The combination of robust prescribing data, patient education, and proactive pharmacovigilance will be essential in continuing to reduce risks associated with valproate in pregnancy while supporting those who rely on the medication for seizure control.
