• Posted March 21, 2024

Common Epilepsy, Migraine Drug Won't Raise Odds for Autism in Offspring

A common antiseizure drug used to treat epilepsy, migraines and bipolar disorder does not appear to increase the risk of autism for kids exposed to it in the womb, a new study says.

Topiramate does not contribute to any risk of kids developing autism if their moms took it during pregnancy, researchers report in the New England Journal of Medicine.

"Our findings provide needed clarity on the possible neurodevelopmental impacts of this commonly used drug,"lead researcher Dr. Sonia Hernández-Díaz, a professor of epidemiology at Harvard T.H. Chan School of Public Health, said in a news release.

"While our primary analyses focused on mothers with epilepsy, the study has implications for moms and moms-to-be who live with other conditions treated by topiramate as well,"she added.

Topiramate can treat epilepsy and migraine by calming overactive nerves in a person's body, experts say.

Another antiseizure drug, lamotrigine, also is safe for expectant mothers to take, researchers found.

However, a third drug, valproate, does appear to increase risk of autism in kids, results show. The results for lamotrigine and valproate are consistent with earlier studies.

Nearly 11% of kids exposed to valproate in the womb developed autism, and the risk increased as moms took larger doses of the drug, researchers report.

Researchers also noted that while topiramate appears safe for a baby's developing brains, it remains linked to an increased risk of cleft palate in newborns.

For the study, researchers analyzed data on nearly 4.3 million pregnant women and their children collected between 2000 and 2020 across two major U.S. health care databases.

Children exposed to topiramate during the second half of pregnancy were compared with kids who'd never been exposed to any antiseizure medication in the womb. Kids exposed to lamotrigine and valproate served as control groups.

Overall, by age 8 children born to mothers with epilepsy have a doubled rate of autism compared to the general population, so seizure control remains important.

About 2% of all kids not exposed to antiseizure medications developed autism. That compared with 4% of children with a mom who had epilepsy but did not take these drugs during pregnancy.

About 6% of kids exposed to topiramate and 4% of kids exposed to lamotrigine developed autism. However, any additional risk from the drugs disappeared after researchers accounted for other variables.

The findings were published March 21.

More information

The Autism Research Institute has more information about autism and epilepsy.

SOURCE: Harvard T.H. Chan School of Public Health, news release, March 20, 2024