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[Comment] New regulations to cut valproate-exposed pregnancies

In 1948, as the UK’s National Health Service (NHS) was born, “neurological” treatments consisted of antibiotics, B12 injections, and phenobarbital or phenytoin.1 Much has changed. In epilepsy alone, there are now about 26 anti-epileptic drugs (AEDs). Through much of this transformation, an AED has provided both hope and concern: valproate. Initially licensed for epilepsy in France in 1967,2 valproate is an effective AED recommended in England by the National Institute for Health and Care Excellence (NICE) as a first-line agent for generalised or unspecified epilepsy and second-line for focal epilepsy.