Anti-seizure medicines in pregnancy
April 2018 to September 2025

About this release

This biannual release by Public Health Scotland reports on anti-seizure medicines (ASMs) dispensed up to 30 September 2025 to patients in Scotland aged 0-54, and specifically in pregnant women. ASMs are used in the management of epilepsy, but also for other conditions such as migraine, bipolar disorder, and some types of pain. The reason for prescribing is not recorded therefore prescribing data is included for all conditions. This summary presents the key messages on prescribing of valproate and topiramate. Further information is available on these and other ASMs in the accompanying dashboard. Valproate taken during pregnancy is known to be associated with an increased risk of both congenital and neurodevelopmental conditions. There is also a possible association between use of valproate by men around the time of conception and an increased risk of neurodevelopmental conditions in their children and therefore prescribing rates for valproate in males are included. Topiramate taken during pregnancy is associated with a higher risk of congenital conditions, low birth weight, and a potential increased risk of neurodevelopmental conditions. For full details and prescribing guidance please see Medicines and Healthcare products Regulatory Agency (MHRA) advice for valproate and topiramate, as well as the commentary section of the dashboard.

For a more detailed review of the safety of anti-seizure medicines in pregnancy see the January 2021 report published by the Commission on Human Medicines (CHM).

Information on developments can be found in the Data Sources section of the dashboard.

All definitions can be found in the Cohort Definitions section and Notes pop-ups in the dashboard.

Individuals should not stop taking ASMs without medical advice. Anyone taking ASMs should speak to their GP or consultant if they have questions about the possible impact of their medicines on a pregnancy.

Main points

Valproate prescribing in pregnancy

• One pregnancy was exposed to valproate between July and December 2024 (the most recent time period for which data is available on complete pregnancies).
• This exposure was not the result of a prescription started during pregnancy.

Topiramate prescribing in pregnancy

• Nineteen pregnancies were exposed to topiramate between July and December 2024 (the most recent time period for which data is available on complete pregnancies).
• Two of these exposures were the result of women being newly prescribed topiramate during pregnancy (with no recorded prescriptions in the previous 12 months). It is possible that these women have previous prescriptions, but the prescribing record was not available for our analysis.

Line chart showing trend in pregnancies exposed to valproate and topiramate, from April 2018 to September 2025 including moving averages.

Close

Chart 1: Pregnancies exposed to valproate and topiramate¹

1. Quarterly average is based on the average of the previous four quarters.
2. The shaded area indicates the period after January 2025, where numbers may start to decline as there may be pregnancies that are still ongoing up to 30 September 2025 that had not been exposed up to that point and may become exposed as the pregnancy progresses

Valproate prescribing  overall in females and males aged 0-54

• 1,988 females were prescribed valproate in the most recent quarter reported (July to September 2025). This has decreased by 53% (from 4,237) since the quarter April to June 2018.
• There were 41 female valproate new starts (females prescribed valproate for the first time in 12 months) in July to September 2025. This has decreased by 68% from 128 in April – June 2018.
• 5,334 males were prescribed valproate in the most recent quarter reported (July to September 2025). This has decreased by 25% (from 7,157) since the quarter April to June 2018.
• There were 84 male valproate new starts (males prescribed valproate for the first time in 12 months) in July to September 2025. This has decreased by 65% from 242 in April – June 2018.

Topiramate prescribing overall in females aged 0-54

• 3,101 females were prescribed topiramate in the most recent quarter reported (July to September 2025). This has decreased by 26% (from 4,171) since the quarter April to June 2018.
• There were 199 female topiramate new starts (females prescribed topiramate for the first time in 12 months) in July to September 2025. This has decreased by 70% from 669 in April – June 2018.

Line chart showing trend in valproate prescribing in both males and females and also topiramate prescribing in females only. From April 2018 to September 2025

Close

Chart 2: Valproate and topiramate new starts by quarter of prescribing

Further information

The next release of this publication will be October 2026.