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The number of women prescribed sodium valproate in pregnancy fell to its lowest level yet in March 2025, NHS England data have revealed.
According to the NHS Medicines and Pregnancy Dashboard, published on 25 September 2025, five women were prescribed valproate while pregnant between October 2024 and March 2025, although none of these women started valproate while pregnant.
In the same five-month period, 75 women stopped taking valproate before becoming pregnant.
The data also revealed that 13,201 women and young females aged 12–54 years old were prescribed valproate in March 2025. This figure was 12,925 in February 2025 and 13,820 in January 2025.
These numbers have almost halved since April 2018, when 25,150 women and girls aged 12–54 were prescribed valproate and new measures were introduced to reduce prescribing of valproate in this age group.
The data suggest a continuing decline in the number of women prescribed valproate while pregnant and number of pregnancies affected by valproate (see Figure).
Nicola Swanborough, head of external affairs at Epilepsy Society, said: “We are pleased to see that the number of women prescribed valproate is reducing and would hope that those still taking the medication are enrolled in the pregnancy prevention programme. This involves taking an effective form of contraception and signing a risk acknowledgement form.
“We do not know whether, for the five women who were prescribed valproate during pregnancy, the risks of stopping the medication were considered to be too high for the mother and baby. Statistics only tell us part of the story.”
Swanborough noted that, for some, valproate may be the only medication that will control their seizures.
“Pharmacists can play a key role in ensuring that women are fully informed about the risks associated with valproate during pregnancy. They are an important touch point in the community where that extra discussion can help raise awareness and ensure that both women and men are supported to make the right decisions for them and any future children,” she commented.
“We will be asking the Medicines and Healthcare products Regulatory Agency to report more fully on the long-term outcomes for both women and men who are switched from valproate or started on a different medication rather than valproate,” she added.
Rachel Arkell, a legal academic, also stressed that the statistics around valproate prescribing in pregnancy “only tells a portion of the story”.
”The known risks associated with valproate seem to be [considered to be] sufficient to move patients to the unknown risks associated with combinations of drugs [prescribed in place of valproate],” she explained.
Switching to a different drug may impact a patient’s way of life and could require patients “to assume a higher level of risk just because they might become pregnant,” Arkell added, stressing that patients should be able to make an informed decision around valproate.
Olga Tanda, an advanced neurology pharmacist at the Great Western Hospitals NHS Foundation Trust, shared how pharmacists in different settings can improve the safety of valproate prescribing.
”In community pharmacy, every time a woman of childbearing age comes in to collect a prescription, it is an invaluable opportunity to make that contact count. Pharmacists can ask about their knowledge of the risks, whether they have discussed alternatives with their specialist, and whether they are using an effective method of contraception to reduce the risk of pregnancy while on valproate.
”In hospital settings, similar opportunities exist for the pharmacy team, including pharmacy technicians. Each encounter allows us to check understanding of the risks, explore whether discussions with specialists have taken place, and confirm effective contraception use,” she said.
”Specialist pharmacist prescribers (e.g. neuropharmacists, epilepsy pharmacists) can complete and update the risk acknowledgement forms directly with patients. Their specialist knowledge and prescribing authority mean they are very competent professionals to drive these conversations.”
However, Tanda added that the role of specialist pharmacist prescribers was still ”under-recognised” in some hospitals, ”with the responsibility left mainly to neurology consultants”.
”This makes keeping reviews up to date less sustainable,” she said.
“There are situations where, despite the risks to the baby, a woman may need to remain on valproate during pregnancy because the dangers of uncontrolled seizures to both mother and foetus are considerable, including the risk of sudden unexpected death in epilepsy. These are not straightforward decisions.”
Commenting on the latest figures, Tanda added: “We treat patients, not numbers. The more important questions are: Was the patient reviewed appropriately? Were alternative drugs considered? Was the patient fully aware of the risks?”
Alison Fuller, director of health improvement and influencing at Epilepsy Action, said that collecting and sharing data on valproate prescribing was a “positive step towards ensuring patient safety”.
“Many individuals are concerned by the possible effects of sodium valproate (valproate) on their children, including birth defects and neurodevelopmental conditions, such as autism, ADHD and learning disabilities,” she said.
“Although there are clear risks associated with pregnancy and valproate, it is important that both women and men are equipped with the right information from their clinicians to make an informed decision about their treatment.”
