‘Conceivably Neglected’ – Are prescribers sufficiently aware of the risks of prescribing sodium valproate to women with mental illness?

Abstract

Objectives: To describe prescription of sodium valproate (SV) for bipolar mood disorder to potentially child-bearing women within one public mental health service and describe risks of fetal exposure, and safe prescribing practices among psychiatrists. Methods: A 24-month retrospective chart review with descriptive analysis; narrative review of literature and guidelines. Results: Review of 383 charts demonstrated prescription of valproate to 20% of 98 women aged 15–45, with little evidence of advice regarding risk and contraception. Robust evidence of teratogenic and neurodevelopmental risk underpins increased regulation, and recommendations that valproate not be prescribed to this cohort. Conclusions: The significant risks associated with SV oblige all prescribers to proactively access authoritative guidelines such as those published by the Centre of Perinatal Excellence.