Access to antiseizure medication in low- and middle-income countries has increased significantly, but safety in prescribing practices remains a critical issue. A study led by Dr. Adrienne Chan and Professor Ian Wong from Aston University, in collaboration with the World Health Organization (WHO), analyzed antiseizure medication use across 73 countries between 2012 and 2022. While the findings indicate a positive trend in access to essential neurological medicines, they also highlight alarming concerns surrounding the use of valproate, a medication known to cause birth defects when taken during pregnancy.
Valproate, which is among the most commonly prescribed antiseizure medications, poses serious risks to unborn children. Research emphasizes that exposure to valproate during pregnancy can lead to conditions such as spina bifida, cleft palate, and various neurodevelopmental disorders affecting memory, behavior, and communication. The WHO recognizes valproate as an “essential medicine” but has issued guidelines advising against its prescription for women and girls of childbearing age due to these risks.
Global Disparities and Safety Concerns
Despite the encouraging increase in medication access, the study underscores a significant disparity in prescribing practices between high-income and low- to middle-income countries. In wealthier nations, stricter regulations and effective pregnancy prevention programs have resulted in a notable decrease in valproate prescriptions. Conversely, in regions where newer antiseizure drugs are less accessible or affordable, valproate continues to be widely prescribed, raising concerns about patient safety.
The WHO commissioned this study to better understand and promote the safe use of essential neurological medicines globally. The research findings have been published in eClinicalMedicine, providing valuable insights into the prescribing trends and highlighting the urgent need for comprehensive education regarding the risks associated with antiseizure medications.
Future Research Directions and Policy Implications
The researchers utilized sales data to assess medication consumption patterns, yet they acknowledge the necessity for more in-depth studies focusing on specific populations. Understanding how safety measures are implemented across different regions will be critical in determining whether antiseizure drugs are being prescribed appropriately to women of childbearing age and assessing the associated risks for unborn children.
Dr. Chan remarked, “Our findings show that access to antiseizure medicines is expanding globally, which is good news for patients who previously had little or no treatment options. But the continued widespread use of valproate in some parts of the world is concerning, given its known risks during pregnancy. Greater global alignment on safe prescribing and education is urgently needed to protect future generations.”
As the global health community continues to grapple with the complexities of medication access and safety, the study serves as a call to action for enhanced regulatory frameworks and educational initiatives that prioritize patient safety, particularly for vulnerable populations. More comprehensive strategies are essential for safeguarding the health of both mothers and their children in the evolving landscape of antiseizure medication usage.
