Anti-Seizure Medicines in Pregnancy
April 2018 - September 2023

About this release

This release by Public Health Scotland reports on anti-seizure medicines (ASMs) prescribed to females in Scotland aged 0-54 and pregnant women. Further details can be found in the publication report and data tables. Information on future developments can also be found in the publication report under 'Planned Developments'.

Main points

Of the 146,632 females aged 0-54 prescribed an anti-seizure medicine between April 2018 and September 2023:

• 58,329 females were prescribed an anti-seizure medicine in the most recent quarter reported (July – September 2023). This figure has remained stable in all quarters during the full period reported (April 2018 – September 2023).

Valproate

• 5,929 females were prescribed valproate between April 2018 and September 2023.
• 2,482 were prescribed valproate in the most recent quarter reported (July – September 2023). This figure has decreased steadily by 42% (from 4,249) since the quarter April – June 2018.
• 75 pregnancies (to 69 women) conceived between April 2018 and September 2023 had been exposed to valproate by 30 September 2023. Of these, 1 was conceived in the most recent 6-month period (April – September 2023).
• Of the 75 valproate-exposed pregnancies conceived between April 2018 and September 2023, 73 (97%) had been exposed during early pregnancy (first trimester).
• In 5 of the 75 valproate-exposed pregnancies conceived between April 2018 and September 2023, valproate was started during pregnancy after the woman had no prescription in the year before pregnancy. It is possible that some of these women had had previous prescriptions, but the prescribing record was not available for our analysis. Of these 5 pregnancies, none were a new starter in the most recent 6 months, April-September 2023
• In 55 pregnancies conceived between April 2018 and September 2023 the woman had a prescription for valproate in the year before pregnancy but none during pregnancy.

Graph showing numbers of females prescribed valproate and topiramate over time from April 2018 to September 2023. Valproate prescribing in this group has reduced by 42% whereas topiramate prescribing has remained steady.

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Graph showing a trend in pregnancies exposed to valproate and topiramate. Figures plotted are quarterly averages. For both medicines these are reducing.

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* Quarterly average is based on the average of the previous four quarters.

Topiramate

• 15,456 females were prescribed topiramate between April 2018 and September 2023.
• 4,253 were prescribed topiramate in the most recent quarter reported (July – September 2023). This figure has remained level since the quarter April – June 2018.
• 268 pregnancies (to 240 women) conceived between April 2018 and September 2023 had been exposed to topiramate by 30 September 2023. Of these, 10 were conceived in the most recent 6-month period (April – September 2023).
• Of the 268 topiramate-exposed pregnancies conceived between April 2018 and September 2023, 264 (99%) had been exposed during early pregnancy (first trimester).
• In 40 of the 268 topiramate-exposed pregnancies conceived between April 2018 and September 2023, topiramate was started during pregnancy after the woman had no prescription in the year before pregnancy. It is possible that some of these women had previous prescriptions, but the prescribing record was not available for our analysis. Of these 40 pregnancies, one was a new starter in the most recent 6 months, April-September 2023
• In 572 pregnancies conceived between April 2018 and September 2023 the woman had a prescription for topiramate in the year before pregnancy but none during pregnancy.

Background

Information on anti-seizure medicines dispensed in community pharmacies and by dispensing doctors, administered during hospital stays, and supplied through Home Care services were combined with pregnancy and births data. Further information on the data can be found in the main report.

Further information

The next release of this publication will be October 2024