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Let’s examine an editorial entitled “Valproate: Time for a Change in Perception” from Dr. David Owens in the British Journal of Psychiatry. We are not looking at new information here but a new perspective, perhaps, from the chair of the European Medicines Agency regarding a review of valproate in pregnancy.
Dr. Owens’s arguments are familiar: They center principally around the high teratogenic risk of valproate. He makes it clear that the risk is much higher than with lithium. The main purpose of his editorial emerges as he goes along—namely, the regulatory agency for prescription medication in the United Kingdom as of mid-2018 added a contraindication in pregnancy and women of childbearing potential for valproate. However, to Dr. Owens’s and others’ disappointment, prescribing practices did not change very much with that regulatory contraindication.
Instead, Dr. Owens asserts that a reduction in valproate use in reproductive-age women will only come from a
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